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Observational Study
. 2021 Oct 22:149:e230.
doi: 10.1017/S095026882100234X.

COVID-19 patients with increasing age experience differential time to initial medical care and severity of symptoms

J Mancilla-Galindo  1 , A Kammar-García  2   3 , A Martínez-Esteban  4 , H D Meza-Comparán  4 , J Mancilla-Ramírez  2   5 , N Galindo-Sevilla  2   6
Affiliations
Observational Study

COVID-19 patients with increasing age experience differential time to initial medical care and severity of symptoms

J Mancilla-Galindo et al. Epidemiol Infect. .

Abstract

We conducted a retrospective observational study in patients with laboratory-confirmed coronavirus disease (COVID-19) who received medical care in 688 COVID-19 ambulatory units and hospitals in Mexico City between 24 February 2020 and 24 December 2020, to study if the elderly seek medical care later than younger patients and their severity of symptoms at initial medical evaluation. Patients were categorised into eight groups (<20, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79 and ≥80 years). Symptoms at initial evaluation were classified according to a previously validated classification into respiratory and non-respiratory symptoms. Comparisons between time from symptom onset to medical care for every age category were performed through variance analyses. Logistic regression models were applied to determine the risk of presenting symptoms of severity according to age, and mortality risk according to delays in medical care. In total, 286 020 patients were included (mean age: 42.8, s.d.: 16.8 years; 50.4% were women). Mean time from symptom onset to medical care was 4.04 (s.d.: 3.6) days and increased with older age categories (P < 0.0001). Mortality risk increased by 6.4% for each day of delay in medical care from symptom onset. The risk of presenting with the symptoms of severity was greater with increasing age categories. In conclusion, COVID-19 patients with increasing ages tend to seek medical care later, with higher rates of symptoms of severity at initial presentation in both ambulatory units and hospitals.

Keywords: Ageing; COVID-19; coronavirus; epidemiology; pandemic.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Contact with confirmed COVID-19 cases, time from symptom onset to medical care and risk of having symptoms of severity at initial presentation in laboratory-confirmed COVID-19 patients in Mexico City. (a) Proportion of patients who had contact with a confirmed COVID-19 case in the last 7 days according to age categories. (b) Mean and 95% CI of time from symptom onset to medical care according to age categories. (c) Risk of respiratory symptoms at initial presentation according to age as a continuous variable. (d) Risk of respiratory symptoms at initial presentation according to age categories. OR, odds ratio; 95% CI, 95% confidence interval.
Fig. 2.
Fig. 2.
Weekly diagnostic testing rates for SARS-CoV-2 in Mexico City according to age categories during 2020.
See this image and copyright information in PMC

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