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  1. Article ; Online: Atypical presentation of COVID-19 in a frail older person.

    Tay, Hui Sian / Harwood, Rowan

    Age and ageing

    2020  Volume 49, Issue 4, Page(s) 523–524

    Abstract: ... of frail older people to COVID-specific clinical facilities and highlights the potential for spread ... Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough. We describe ... opacification. A postmortem throat swab identified COVID-19 infection. He was treated in three wards over 5 days ...

    Abstract Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough. We describe a 94-year-old man with well-controlled schizoaffective disorder, who presented with non-specific and atypical symptoms: delirium, low-grade pyrexia and abdominal pain. He was given antibiotics for infection of unknown source, subsequently refined to treatment for community-acquired pneumonia. Despite active treatment, he deteriorated with oxygen desaturation and tachypnoea. A repeat chest X-ray showed widespread opacification. A postmortem throat swab identified COVID-19 infection. He was treated in three wards over 5 days with no infection control precautions. This has implications for the screening, assessment and isolation of frail older people to COVID-specific clinical facilities and highlights the potential for spread among healthcare professionals and other patients.
    MeSH term(s) Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Delirium/diagnosis ; Delirium/etiology ; Frail Elderly ; Frailty/epidemiology ; Humans ; Male ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Radiography, Thoracic ; SARS-CoV-2 ; Tomography, X-Ray Computed
    Keywords covid19
    Language English
    Publishing date 2020-05-04
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afaa068
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 877: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 448: Show issues

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  2. Article: Atypical presentation of COVID-19 in a frail older person

    Tay, Hui Sian / Harwood, Rowan

    Age Ageing

    Abstract: ... of frail older people to COVID-specific clinical facilities and highlights the potential for spread ... Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough. We describe ... opacification. A postmortem throat swab identified COVID-19 infection. He was treated in three wards over 5 days ...

    Abstract Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough. We describe a 94-year-old man with well-controlled schizoaffective disorder, who presented with non-specific and atypical symptoms: delirium, low-grade pyrexia and abdominal pain. He was given antibiotics for infection of unknown source, subsequently refined to treatment for community-acquired pneumonia. Despite active treatment, he deteriorated with oxygen desaturation and tachypnoea. A repeat chest X-ray showed widespread opacification. A postmortem throat swab identified COVID-19 infection. He was treated in three wards over 5 days with no infection control precautions. This has implications for the screening, assessment and isolation of frail older people to COVID-specific clinical facilities and highlights the potential for spread among healthcare professionals and other patients.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #101203
    Database COVID19

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  3. Article ; Online: Atypical presentation of COVID-19 in a frail older person

    Tay, Hui Sian / Harwood, Rowan

    Age and Ageing

    2020  Volume 49, Issue 4, Page(s) 523–524

    Abstract: ... assessment and isolation of frail older people to COVID-specific clinical facilities and highlights ... Abstract Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough ... widespread opacification. A postmortem throat swab identified COVID-19 infection. He was treated in three ...

    Abstract Abstract Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough. We describe a 94-year-old man with well-controlled schizoaffective disorder, who presented with non-specific and atypical symptoms: delirium, low-grade pyrexia and abdominal pain. He was given antibiotics for infection of unknown source, subsequently refined to treatment for community-acquired pneumonia. Despite active treatment, he deteriorated with oxygen desaturation and tachypnoea. A repeat chest X-ray showed widespread opacification. A postmortem throat swab identified COVID-19 infection. He was treated in three wards over 5 days with no infection control precautions. This has implications for the screening, assessment and isolation of frail older people to COVID-specific clinical facilities and highlights the potential for spread among healthcare professionals and other patients.
    Keywords Ageing ; Geriatrics and Gerontology ; General Medicine ; covid19
    Language English
    Publisher Oxford University Press (OUP)
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afaa068
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 877: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 448: Show issues

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  4. Article ; Online: Atypical presentations of COVID-19 in care home residents presenting to secondary care: A UK single centre study.

    Rawle, Mark James / Bertfield, Deborah Lee / Brill, Simon Edward

    Aging medicine (Milton (N.S.W))

    2020  Volume 3, Issue 4, Page(s) 237–244

    Abstract: ... mortality of COVID-19 in older adults, focusing on care home residents admitted to secondary care ... likely to experience cough (46.9% vs 72.9%, : Conclusion: COVID-19 in older adults often presents ... Background: Atypical presentations of COVID-19 pose difficulties for early isolation and treatment ...

    Abstract Background: Atypical presentations of COVID-19 pose difficulties for early isolation and treatment, particularly in institutional care settings. We aimed to characterize the presenting symptoms and associated mortality of COVID-19 in older adults, focusing on care home residents admitted to secondary care.
    Methods: A retrospective cohort study of 134 consecutive inpatients over 80 years old hospitalized with PCR confirmed COVID-19 in the United Kingdom. Symptoms at presentation and frailty were analysed. Differences between community dwelling and care home residents, and associations with mortality, were assessed using between-group comparisons and logistic regression.
    Results: Care home residents were less likely to experience cough (46.9% vs 72.9%,
    Conclusion: COVID-19 in older adults often presents with atypical symptoms, particularly in those admitted from institutional care. These individuals have a reduced incidence of cough and increased hypoactive delirium. Individuals presenting atypically, especially with anorexia, have higher mortality.
    Language English
    Publishing date 2020-09-17
    Publishing country Australia
    Document type Journal Article
    ISSN 2475-0360
    ISSN (online) 2475-0360
    DOI 10.1002/agm2.12126
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Atypical symptoms, SARS-CoV-2 test results and immunisation rates in 456 residents from eight nursing homes facing a COVID-19 outbreak.

    Blain, Hubert / Gamon, Lucie / Tuaillon, Edouard / Pisoni, Amandine / Giacosa, Nadia / Albrand, Mylène / Miot, Stéphanie / Rolland, Yves / Picot, Marie-Christine / Bousquet, Jean

    Age and ageing

    2021  Volume 50, Issue 3, Page(s) 641–648

    Abstract: Background: Frail older persons may have an atypical presentation of coronavirus disease 2019 ... COVID-19). The value of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) testing ... SARS-CoV-2 cases, (ii) rT-PCR testing for identifying COVID-19 residents, (iii) repeated wide-facility ...

    Abstract Background: Frail older persons may have an atypical presentation of coronavirus disease 2019 (COVID-19). The value of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) testing for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nursing homes (NHs) residents is not known.
    Objective: To determine whether (i) atypical symptoms may predict rRT-PCR results and (ii) rRT-PCR results may predict immunisation against SARS-CoV-2 in NH residents.
    Design: A retrospective longitudinal study.
    Setting: Eight NHs with at least 10 rRT-PCR-positive residents.
    Subjects: A total of 456 residents.
    Methods: Typical and atypical symptoms recorded in residents' files during the 14 days before and after rRT-PCR testing were analysed. Residents underwent blood testing for IgG-SARS-CoV-2 nucleocapsid protein 6 to 8 weeks after testing. Univariate and multivariate analyses compared symptoms and immunisation rates in rRT-PCR-positive and negative residents.
    Results: A total of 161 residents had a positive rRT-PCR (35.3%), 17.4% of whom were asymptomatic before testing. Temperature >37.8°C, oxygen saturation <90%, unexplained anorexia, behavioural change, exhaustion, malaise and falls before testing were independent predictors of a further positive rRT-PCR. Among the rRT-PCR-positive residents, 95.2% developed SARS-CoV-2 antibodies vs 7.6% in the rRT-PCR-negative residents. Among the residents with a negative rRT-PCR, those who developed SARS-CoV-2 antibodies more often had typical or atypical symptoms (P = 0.02 and <0.01, respectively).
    Conclusion: This study supports a strategy based on (i) testing residents with typical or unexplained atypical symptoms for an early identification of the first SARS-CoV-2 cases, (ii) rT-PCR testing for identifying COVID-19 residents, (iii) repeated wide-facility testing (including asymptomatic cases) as soon as a resident is tested positive for SARS-CoV-2 and (iv) implementing SARS-CoV-2 infection control measures in rRT-PCR-negative residents when they have unexplained typical or atypical symptoms.
    MeSH term(s) Accidental Falls ; Aged ; Aged, 80 and over ; Anorexia ; Antibodies, Viral/blood ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Nucleic Acid Testing ; Disease Outbreaks/prevention & control ; False Negative Reactions ; False Positive Reactions ; Female ; Humans ; Immunization ; Immunoglobulin G/blood ; Longitudinal Studies ; Male ; Nursing Homes ; Pandemics ; Polymerase Chain Reaction ; Retrospective Studies ; SARS-CoV-2/immunology ; Sensitivity and Specificity ; Serologic Tests/methods
    Chemical Substances Antibodies, Viral ; Immunoglobulin G
    Language English
    Publishing date 2021-02-23
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afab050
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 877: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 448: Show issues

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  6. Article ; Online: Atypical Presentations of COVID-19 in Care Home Residents presenting to Secondary Care: A UK Single Centre Study

    Rawle, Mark James / Bertfield, Deborah Lee / Brill, Simon Edward

    medRxiv

    Abstract: ... the COVID-19 pandemic. Atypical presentations of COVID-19 are being reported in older adults and may pose ... to characterise the presenting symptoms and associated mortality of COVID-19 in older adults, with a focus ... from care homes and community dwelling older adults. Conclusion: COVID-19 in those over 80 does not always present ...

    Abstract Background: The United Kingdom (UK) care home population has experienced high mortality during the COVID-19 pandemic. Atypical presentations of COVID-19 are being reported in older adults and may pose difficulties for early isolation and treatment, particularly in institutional care settings. We aimed to characterise the presenting symptoms and associated mortality of COVID-19 in older adults, with a focus on care home residents and older adults living in the community. Methods: This was a retrospective cohort study of consecutive inpatients over 80 years old hospitalised with PCR confirmed COVID-19 between 10th March 2020 and 8th April 2020. Symptoms at presentation, including those associated with frailty, were analysed. Differences between community dwelling and care home residents, and associations with mortality, were assessed using between-group comparisons and logistic regression. Results: Care home residents were less likely to experience cough (46.9% vs 72.9%, p=0.002) but more likely to present with delirium (51.6% vs 31.4%, p=0.018), particularly hypoactive delirium (40.6% vs 24.3%, p=0.043). Mortality was more likely in the very frail (OR 1.25, 95% CI 1.00, 1.58, p=0.049) and those presenting with anorexia (OR 3.20, 95% CI 1.21, 10.09, p=0.028). There were no differences in either mortality or length of stay between those admitted from care homes and community dwelling older adults. Conclusion: COVID-19 in those over 80 does not always present with typical symptoms, particularly in those admitted from institutional care. These individuals have a reduced incidence of cough and increased hypoactive delirium. Individuals presenting atypically, especially with anorexia, have higher mortality.
    Keywords covid19
    Language English
    Publishing date 2020-07-08
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.07.07.20148148
    Database COVID19

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  7. Article ; Online: Atypical Presentations of COVID-19 in Care Home Residents presenting to Secondary Care: A UK Single Centre Study

    Rawle, M. J. / Bertfield, D. L. / Brill, S. E.

    Abstract: ... the COVID-19 pandemic. Atypical presentations of COVID-19 are being reported in older adults and may pose ... to characterise the presenting symptoms and associated mortality of COVID-19 in older adults, with a focus ... from care homes and community dwelling older adults. Conclusion: COVID-19 in those over 80 does not always present ...

    Abstract Background: The United Kingdom (UK) care home population has experienced high mortality during the COVID-19 pandemic. Atypical presentations of COVID-19 are being reported in older adults and may pose difficulties for early isolation and treatment, particularly in institutional care settings. We aimed to characterise the presenting symptoms and associated mortality of COVID-19 in older adults, with a focus on care home residents and older adults living in the community. Methods: This was a retrospective cohort study of consecutive inpatients over 80 years old hospitalised with PCR confirmed COVID-19 between 10th March 2020 and 8th April 2020. Symptoms at presentation, including those associated with frailty, were analysed. Differences between community dwelling and care home residents, and associations with mortality, were assessed using between-group comparisons and logistic regression. Results: Care home residents were less likely to experience cough (46.9% vs 72.9%, p=0.002) but more likely to present with delirium (51.6% vs 31.4%, p=0.018), particularly hypoactive delirium (40.6% vs 24.3%, p=0.043). Mortality was more likely in the very frail (OR 1.25, 95% CI 1.00, 1.58, p=0.049) and those presenting with anorexia (OR 3.20, 95% CI 1.21, 10.09, p=0.028). There were no differences in either mortality or length of stay between those admitted from care homes and community dwelling older adults. Conclusion: COVID-19 in those over 80 does not always present with typical symptoms, particularly in those admitted from institutional care. These individuals have a reduced incidence of cough and increased hypoactive delirium. Individuals presenting atypically, especially with anorexia, have higher mortality.
    Keywords covid19
    Publisher MedRxiv; WHO
    Document type Article ; Online
    DOI 10.1101/2020.07.07.20148148
    Database COVID19

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