About: Delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults

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About: Delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults
Creator	Bowyer, Ruth Lochlainn, Mary Steves, Claire Visconti, Alessia El-Sayed Moustafa, Julia Martin, Finbarr Roberts, Amy Bao, Mbbch Dooley, Hannah Freydin, Maxim Lee Msc, Karla Ma, Jonathan Mangino Phd, Massimo Modat Phd, Marc Mres, Carly Murray Msc, Benjamin Ourselin Phd, Sebastien Penfold Bmbch, Rose Small Phd, Kerrin Sudre Phd, Carole Zazzara, Maria
source	MedRxiv
abstract	Background: Frailty, increased vulnerability to physiological stressors, is associated with adverse outcomes. COVID-19 exhibits a more severe disease course in older, co-morbid adults. Awareness of atypical presentations is critical to facilitate early identification. Objective: To assess how frailty affects presenting COVID-19 symptoms in older adults. Design: Observational cohort study of hospitalised older patients and self-report data for community-based older adults. Setting: Admissions to St Thomas' Hospital, London with laboratory-confirmed COVID-19. Community-based data for 535 older adults using the COVID Symptom Study mobile application. Subjects: Hospital cohort: patients aged 65 and over (n=322); unscheduled hospital admission between March 1st, 2020 - May 5th, 2020; COVID-19 confirmed by RT-PCR of nasopharyngeal swab. Community-based cohort: participants aged 65 and over enrolled in the COVID Symptom Study (n=535); reported test-positive for COVID-19 from March 24th (application launch)- May 8th, 2020. Methods: Multivariate logistic regression analysis performed on age-matched samples from hospital and community-based cohorts to ascertain association of frailty with symptoms of confirmed COVID-19. Results: Hospital cohort: significantly higher prevalence of delirium in the frail sample, with no difference in fever or cough. Community-based cohort: significantly higher prevalence of probable delirium in frailer, older adults, and fatigue and shortness of breath. Conclusions: This is the first study demonstrating higher prevalence of delirium as a COVID-19 symptom in older adults with frailty compared to other older adults. This emphasises need for systematic frailty assessment and screening for delirium in acutely ill older patients in hospital and community settings. Clinicians should suspect COVID-19 in frail adults with delirium.
has issue date	2020-06-17(xsd:dateTime)
bibo:doi	10.1101/2020.06.15.20131722
has license	medrxiv
sha1sum (hex)	f76b0e465e94c6dbb7dd13601bf575b5644fa34a
schema:url	https://doi.org/10.1101/2020.06.15.20131722
resource representing a document's title	Delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults
resource representing a document's body	covid:f76b0e465e94c6dbb7dd13601bf575b5644fa34a#body_text
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is part of of	covid:f76b0e465e94c6dbb7dd13601bf575b5644fa34a#body_text Delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults Background: Frailty, increased vulnerability to physiological stressors, is associated with adverse outcomes. COVID-19 exhibits a more severe disease course in older, co-morbid adults. Awareness of atypical presentations is critical to facilitate early identification. Objective: To assess how frailty affects presenting COVID-19 symptoms in older adults. Design: Observational cohort study of hospitalised older patients and self-report data for community-based older adults. Setting: Admissions to St Thomas' Hospital, London with laboratory-confirmed COVID-19. Community-based data for 535 older adults using the COVID Symptom Study mobile application. Subjects: Hospital cohort: patients aged 65 and over (n=322); unscheduled hospital admission between March 1st, 2020 - May 5th, 2020; COVID-19 confirmed by RT-PCR of nasopharyngeal swab. Community-based cohort: participants aged 65 and over enrolled in the COVID Symptom Study (n=535); reported test-positive for COVID-19 from March 24th (application launch)- May 8th, 2020. Methods: Multivariate logistic regression analysis performed on age-matched samples from hospital and community-based cohorts to ascertain association of frailty with symptoms of confirmed COVID-19. Results: Hospital cohort: significantly higher prevalence of delirium in the frail sample, with no difference in fever or cough. Community-based cohort: significantly higher prevalence of probable delirium in frailer, older adults, and fatigue and shortness of breath. Conclusions: This is the first study demonstrating higher prevalence of delirium as a COVID-19 symptom in older adults with frailty compared to other older adults. This emphasises need for systematic frailty assessment and screening for delirium in acutely ill older patients in hospital and community settings. Clinicians should suspect COVID-19 in frail adults with delirium.

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