دورية أكاديمية
Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes.
| العنوان: | Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes. |
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| المؤلفون: | van Son JE; Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Location ETZ Elisabeth, Post Office Box 90151, 5000 LC, Tilburg, The Netherlands. je.vanson@etz.nl., Kahn ECP; Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine, Gelre Hospitals, Apeldoorn and Zutphen, The Netherlands., van der Bol JM; Department of Geriatric Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Barten DG; Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands., Blomaard LC; Section Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands., van Dam C; Division of Geriatric Medicine, Department of Internal Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands., Ellerbroek J; Department of Internal Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Jansen SWM; Department of Geriatric Medicine, Catharina Hospital, Eindhoven, The Netherlands., Lekx A; Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands., van der Linden CMJ; Department of Geriatric Medicine, Catharina Hospital, Eindhoven, The Netherlands., Looman R; Division of Geriatric Medicine, Department of Internal Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands., Maas HAAM; Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Location ETZ Elisabeth, Post Office Box 90151, 5000 LC, Tilburg, The Netherlands., Mattace-Raso FUS; Department of Internal Medicine, Division of Geriatric Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Mooijaart SP; Section Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands., van Munster BC; Department of Internal Medicine and Geriatrics, University Medical Centre Groningen, Groningen, The Netherlands., Peters A; Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands., Polinder-Bos HA; Department of Internal Medicine, Division of Geriatric Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Smits RAL; Section Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands., Spies PE; Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine, Gelre Hospitals, Apeldoorn and Zutphen, The Netherlands., Wassenburg A; Department of Geriatric Medicine, Alrijne Hospital, Leiderdorp, The Netherlands., Wassenburg N; Department of Geriatric Medicine, Alrijne Hospital, Leiderdorp, The Netherlands., Willems HC; Section Geriatrics, Department of Internal Medicine, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands., Schouten HJ; Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine, Gelre Hospitals, Apeldoorn and Zutphen, The Netherlands., Robben SHM; Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Location ETZ Elisabeth, Post Office Box 90151, 5000 LC, Tilburg, The Netherlands. |
| المصدر: | European geriatric medicine [Eur Geriatr Med] 2023 Apr; Vol. 14 (2), pp. 333-343. Date of Electronic Publication: 2023 Feb 07. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Publishing Country of Publication: Switzerland NLM ID: 101533694 Publication Model: Print-Electronic Cited Medium: Print ISSN: 1878-7649 (Print) Linking ISSN: 18787649 NLM ISO Abbreviation: Eur Geriatr Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : Cham : Springer International Publishing Original Publication: Issy-les-Moulineaux, Paris : Elsevier Masson SAS |
| مواضيع طبية MeSH: | COVID-19*/complications , COVID-19*/diagnosis , COVID-19*/epidemiology , Frailty*/complications , Frailty*/diagnosis , Frailty*/epidemiology, Aged ; Humans ; Cohort Studies ; Frail Elderly ; Retrospective Studies |
| مستخلص: | Purpose: Older patients with COVID-19 can present with atypical complaints, such as falls or delirium. In other diseases, such an atypical presentation is associated with worse clinical outcomes. However, it is not known whether this extends to COVID-19. We aimed to study the association between atypical presentation of COVID-19, frailty and adverse outcomes, as well as the incidence of atypical presentation. Methods: We conducted a retrospective observational multi-center cohort study in eight hospitals in the Netherlands. We included patients aged ≥ 70 years hospitalized with COVID-19 between February 2020 until May 2020. Atypical presentation of COVID-19 was defined as presentation without fever, cough and/or dyspnea. We collected data concerning symptoms on admission, demographics and frailty parameters [e.g., Charlson Comorbidity Index (CCI) and Clinical Frailty Scale (CFS)]. Outcome data included Intensive Care Unit (ICU) admission, discharge destination and 30-day mortality. Results: We included 780 patients, 9.5% (n = 74) of those patients had an atypical presentation. Patients with an atypical presentation were older (80 years, IQR 76-86 years; versus 79 years, IQR 74-84, p = 0.044) and were more often classified as severely frail (CFS 6-9) compared to patients with a typical presentation (47.6% vs 28.7%, p = 0.004). Overall, there was no significant difference in 30-day mortality between the two groups in univariate analysis (32.4% vs 41.5%; p = 0.173) or in multivariate analysis [OR 0.59 (95% CI 0.34-1.0); p = 0.058]. Conclusions: In this study, patients with an atypical presentation of COVID-19 were more frail compared to patients with a typical presentation. Contrary to our expectations, an atypical presentation was not associated with worse outcomes. (© 2023. The Author(s), under exclusive licence to European Geriatric Medicine Society.) |
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| فهرسة مساهمة: | Keywords: Atypical presentation; COVID-19; Frailty; Older adults; SARS-CoV-2 |
| تواريخ الأحداث: | Date Created: 20230207 Date Completed: 20230420 Latest Revision: 20230524 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9902812 |
| DOI: | 10.1007/s41999-022-00736-z |
| PMID: | 36749454 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. | تدمد: | 1878-7649 |
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| DOI: | 10.1007/s41999-022-00736-z |