Atypical presentations in the hospitalised older adult testing positive for SARS-CoV-2: a retrospective observational study in Glasgow, Scotland
- Resource Type
- Authors
- Amy Bryan; Ren Ping Lee; Steven Wishart; Thomas J. Evans; Jamie Ingram; Lara Mitchell; Emily Cecilia Wright; Eileen Capek; Elizabeth Burleigh; Jon Godwin; Peter G Davis; Rory Gibson
- Source
- Scottish Medical Journal
- Subject
- Male
Pediatrics
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Frail Elderly
older people
03 medical and health sciences
0302 clinical medicine
COVID-19 Testing
delirium
prognostic indicators
Pandemic
Medicine
Humans
030212 general & internal medicine
Aged
Retrospective Studies
Aged, 80 and over
Cross Infection
Frailty
business.industry
Mortality rate
Nosocomial transmission
Age Factors
COVID-19
Retrospective cohort study
General Medicine
Middle Aged
Prognosis
Scotland
Delirium
Female
Original Article
medicine.symptom
Severe Acute Respiratory Syndrome Coronavirus 2, Coronavirus Disease 2019
business
Older people
030217 neurology & neurosurgery
- Language
- ISSN
- 0036-9330
Introduction: Understanding of how SARS-CoV-2 manifests itself in older adults was unknown at the outset of the pandemic. We undertook a retrospective observational analysis of all patients admitted to older people’s services with confirmed COVID-19 in one of the largest hospitals in Europe. We detail presenting symptoms, prognostic features and vulnerability to nosocomial spread. Methods: We retrospectively collected data for each patient with a positive SARSCoV-2 RT PCR between 18th March and the 20th April 2020 in a department of medicine for the elderly in Glasgow. Results: 222 patients were included in our analysis. Age ranged from 56 to 99 years (mean = 82) and 148 were female (67%). 119 patients had a positive swab for SARS-CoV-2 within the first 14 days of admission, only 32% of these patients presented with primarily a respiratory type illness. 103 patients (46%) tested positive after 14 days of admission – this was felt to represent likely nosocomial infection. 95 patients (43%) died by day 30 after diagnosis. Discussion: This data indicates that older people were more likely to present with non-respiratory symptoms. High clinical frailty scores, severe lymphopenia and cumulative comorbidities were associated with higher mortality rates. Several contributing factors will have led to nosocomial transmission.