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. 2020 Dec;11(6):1089-1094.
doi: 10.1007/s41999-020-00373-4. Epub 2020 Jul 30.

Presenting features of COVID-19 in older people: relationships with frailty, inflammation and mortality

Paul Knopp  1 , Amy Miles  1 , Thomas E Webb  1 , Benjamin C Mcloughlin  1 , Imran Mannan  1 , Nadia Raja  1 , Bettina Wan  1 , Daniel Davis  2   3
Affiliations

Presenting features of COVID-19 in older people: relationships with frailty, inflammation and mortality

Paul Knopp et al. Eur Geriatr Med. 2020 Dec.

Abstract

Purpose: To describe the clinical features of COVID-19 in older adults, and relate these to outcomes.

Methods: A cohort study of 217 individuals (median age 80, IQR 74-85 years; 62% men) hospitalised with COVID-19, followed up for all-cause mortality, was conducted. Secondary outcomes included cognitive and physical function at discharge. C-reactive protein and neutrophil:lymphocyte ratio were used as measures of immune activity.

Results: Cardinal COVID-19 symptoms (fever, dyspnoea, cough) were common but not universal. Inflammation on hospitalisation was lower in frail older adults. Fever, dyspnoea, delirium and inflammation were associated with mortality. Delirium at presentation was an independent risk factor for cognitive decline at discharge.

Conclusions: COVID-19 may present without cardinal symptoms as well as implicate a possible role for age-related changes in immunity in mediating the relationship between frailty and mortality.

Keywords: COVID-19; Epidemiology; Immune dysfunction; Mortality; Post-hospitalisation outcomes.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Euler diagram of common presenting clinical symptoms (a) and frailty syndromes (b) in hospitalised older adults with COVID-19. The denominator for each figure separately is the total sample (n = 217)
Fig. 2
Fig. 2
Relationship between immune activity on hospitalisation by degree of frailty and possible divergent routes to mortality
See this image and copyright information in PMC

Comment in

References

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