Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19–A retrospective cohort study

Linda Katharina Karlsson, Lasse Hjort Jakobsen, Louise Hollensberg, Jesper Ryg, Mette Midttun, Henrik Frederiksen, Andreas Glenthøj, Anette Raskov Kodahl, Joanna Secher-Johnsen, Lene Kongsgaard Nielsen, Nuria Gonzalez Bofill, Fredrikke Christie Knudtzen, Cecilia Margareta Lund*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has great health implications in older patients, including high mortality. In general, older patients often have atypical symptom presentations during acute illness due to a high level of comorbidity. The purpose of this study was to investigate the presentation of symptoms at hospital admissions in older patients with COVID-19 and evaluate its impact on disease outcome. Methods: This retrospective study included patients ≥80 years of age with a positive test for SARS-CoV-2, who were admitted to one of three medical departments in Denmark from March 1st to June 1st, 2020. Results: A total of 102 patients (47% male) with a mean age of 85 years were included. The most common symptoms at admission were fever (74%), cough (62%), and shortness of breath (54%). Furthermore, atypical symptoms like confusion (29%), difficulty walking (13%), and falls (8%) were also present. In-hospital and 30-day mortality were 31% (n = 32) and 41% (n = 42), respectively. Mortality was highest in patients with confusion (50% vs 38%) or falls (63% vs 39%), and nursing home residency prior to hospital admission was associated with higher mortality (OR 2.7, 95% CI 1.1–6.7). Conclusions: Older patients with SARS-Cov-2 displayed classical symptoms of COVID-19 but also geriatric frailty symptoms such as confusion and walking impairments. Additionally, both in-hospital and 30-day mortality was very high. Our study highlights the need for preventive efforts to keep older people from getting COVID-19 and increased awareness of frailty among those with COVID-19.

Original languageEnglish
Article number104335
JournalArchives of Gerontology and Geriatrics
Volume94
ISSN0167-4943
DOIs
Publication statusPublished - 1. May 2021

Keywords

  • Delirium
  • Falls
  • Frailty
  • Multimorbidities
  • SARS-CoV-2

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