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

doi:10.1016/j.archger.2020.104335

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

Publikation: Bidrag til tidsskrift › Artikel › Forskning › peer 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.

Originalsprog	Engelsk
Artikelnummer	104335
Antal sider	7
Tidsskrift	Archives of Gerontology and Geriatrics
Vol/bind	94
DOI	https://doi.org/10.1016/j.archger.2020.104335
Status	Udgivet - 2021

Bibliografisk note

Adgang til dokumentet

10.1016/j.archger.2020.104335

Citationsformater

Karlsson, L. K., Jakobsen, L. H., Hollensberg, L., Ryg, J., Midttun, M., Frederiksen, H., Glenthøj, A., Kodahl, A. R., Secher-Johnsen, J., Nielsen, L. K., Bofill, N. G., Knudtzen, F. C., & Lund, C. M. (2021). Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19-A retrospective cohort study. Archives of Gerontology and Geriatrics, 94, Artikel 104335. https://doi.org/10.1016/j.archger.2020.104335

@article{341e5c9e094847219d6b43e52762fa65,

title = "Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19-A retrospective cohort study",

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.",

keywords = "Aged, Aged, 80 and over, COVID-19, Comorbidity, Female, Frailty/epidemiology, Hospitalization, Humans, Male, Retrospective Studies, SARS-CoV-2",

author = "Karlsson, {Linda Katharina} and Jakobsen, {Lasse Hjort} and Louise Hollensberg and Jesper Ryg and Mette Midttun and Henrik Frederiksen and Andreas Glenth{\o}j and Kodahl, {Anette Raskov} and Joanna Secher-Johnsen and Nielsen, {Lene Kongsgaard} and Bofill, {Nuria Gonzalez} and Knudtzen, {Fredrikke Christie} and Lund, {Cecilia Margareta}",

note = "Copyright {\textcopyright} 2020. Published by Elsevier B.V.",

year = "2021",

doi = "10.1016/j.archger.2020.104335",

language = "English",

volume = "94",

journal = "Archives of Gerontology and Geriatrics",

issn = "0167-4943",

publisher = "Elsevier Ireland Ltd",

}

Karlsson, LK, Jakobsen, LH, Hollensberg, L, Ryg, J, Midttun, M, Frederiksen, H, Glenthøj, A, Kodahl, AR, Secher-Johnsen, J, Nielsen, LK, Bofill, NG, Knudtzen, FC & Lund, CM 2021, 'Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19-A retrospective cohort study', Archives of Gerontology and Geriatrics, bind 94, 104335. https://doi.org/10.1016/j.archger.2020.104335

TY - JOUR

T1 - Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19-A retrospective cohort study

AU - Karlsson, Linda Katharina

AU - Jakobsen, Lasse Hjort

AU - Hollensberg, Louise

AU - Ryg, Jesper

AU - Midttun, Mette

AU - Frederiksen, Henrik

AU - Glenthøj, Andreas

AU - Kodahl, Anette Raskov

AU - Secher-Johnsen, Joanna

AU - Nielsen, Lene Kongsgaard

AU - Bofill, Nuria Gonzalez

AU - Knudtzen, Fredrikke Christie

AU - Lund, Cecilia Margareta

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - Aged

KW - Aged, 80 and over

KW - COVID-19

KW - Comorbidity

KW - Female

KW - Frailty/epidemiology

KW - Hospitalization

KW - Humans

KW - Male

KW - Retrospective Studies

KW - SARS-CoV-2

U2 - 10.1016/j.archger.2020.104335

DO - 10.1016/j.archger.2020.104335

M3 - Article

C2 - 33476754

SN - 0167-4943

VL - 94

JO - Archives of Gerontology and Geriatrics

JF - Archives of Gerontology and Geriatrics

M1 - 104335

ER -

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

Abstract

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