Atypical presentation of COVID-19 in hospitalised older adults.
Atypical presentation of COVID-19 in hospitalised older adults.
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DOI：
10.1007/s11845-020-02372-7
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发表时间：
2021-05
影响因子：
2.1
通讯作者：
Missouris CG
中科院分区：
文献类型：
--
作者：
Gan JM;Kho J;Akhunbay-Fudge M;Choo HM;Wright M;Batt F;Mandal AKJ;Chauhan R;Missouris CG
人们越来越认识到，老年患者可能不会出现COVID-19的典型症状。本研究旨在评估非典型表现的COVID-19老年人的发病率、特征和临床结局。对2020年3月1日至4月24日期间在我们机构住院的确诊COVID-19的≥ 65岁成人进行了回顾性分析。根据社区的主要主诉将患者分为典型或非典型组。纳入122例患者（平均年龄81 ± 8岁; 62例男性）。73例（60%）被归类为典型组，49例（40%）被归类为非典型组。在非典型组中，常见的主诉是18例（36%）跌倒，18例（36%）活动减少或全身无力，11例（22%）谵妄。护理人员和入院时的进一步评估发现，32人（65%）具有COVID-19的典型特征，发烧是最常见的，22人（44%）缺氧。该亚组的结局比典型组更差，死亡率分别为50%和38%，尽管这在统计学上不显著（P = 0.27）。两组之间的死亡率或住院时间无显著差异。社区中非典型COVID-19表现的老年患者同样容易出现不良结局。早期发现可能会改善结果并限制社区传播。初级保健从业人员应保持警惕，并考虑迅速转介。
It is increasingly recognised that older patients may not present with typical symptoms of COVID-19. This study aims to evaluate the incidence, characteristics and clinical outcome of older adults with atypical presentations of COVID-19. A retrospective analysis of adults ≥ 65 years with confirmed COVID-19 admitted to our institution between 1 March and 24 April 2020 was performed. Patients were categorised into typical or atypical groups based on primary presenting complaint in the community. One hundred twenty-two patients (mean age 81 ± 8 years; 62 male) were included. Seventy-three (60%) were categorised into the typical group and 49 (40%) into the atypical group. In the atypical group, common presenting complaints were fall in 18 (36%), reduced mobility or generalised weakness in 18 (36%) and delirium in 11 (22%). Further assessment by paramedics and on admission found 32 (65%) to have typical features of COVID-19, fever being the most common, and 22 (44%) were hypoxic. This subset had worse outcomes than those in the typical group with a mortality rate of 50% versus 38%, respectively, although this was not statistically significant (P = 0.27). No significant difference in mortality or length of hospital stay between the groups was demonstrated. Older patients with atypical presentation of COVID-19 in the community are equally susceptible to poor outcomes. Early detection may improve outcomes and limit community transmission. Primary care practitioners should be vigilant and consider prompt onward referral.
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DOI：
10.1590/0001-3765201720160487
发表时间：
2017-03-01
期刊：
Anais da Academia Brasileira de Ciências
影响因子：
--
作者：
FUENTES, EDUARDO;FUENTES, MANUEL;PALOMO, IVÁN
通讯作者：
PALOMO, IVÁN
影响因子：
11.8
作者：
Norman, DC
通讯作者：
Norman, DC
影响因子：
158.5
作者：
Guan, W.;Ni, Z.;Zhong, N.
通讯作者：
Zhong, N.
阐明妄想的病理生理学：重点是异常压力反应的作用。
影响因子：
4.7
作者：
MacLullich, Alasdair M. J.;Ferguson, Karen J.;Miller, Thomas;de Rooij, Sophia E. J. A.;Cunningham, Colm
通讯作者：
Cunningham, Colm
影响因子：
168.9
作者：
Zhou, Fei;Yu, Ting;Cao, Bin
通讯作者：
Cao, Bin