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Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Coronavirus in the elderly: a late lockdown UK cohort
Andrew D Kerr1, Sybil Rl Stacpoole2
1North West Anglia NHS Foundation Trust.
Insights
Identifying the source of coronavirus disease 2019 (COVID-19) in the elderly is crucial. Many older adults present with symptoms other than cough or fever, necessitating increased vigilance and testing.
Area of Science:
- Infectious Diseases
- Geriatric Medicine
- Public Health
Background:
- Ongoing coronavirus disease 2019 (COVID-19) infections pose a challenge during lockdown periods.
- The elderly are a high-risk group for severe COVID-19 outcomes.
- Understanding transmission sources and clinical presentations in this demographic is vital for effective control.
Purpose of the Study:
- To determine the origin of sustained COVID-19 infections after four weeks of lockdown.
- To characterize the clinical presentation of COVID-19 specifically in elderly individuals.
Main Methods:
- A retrospective observational cohort study was conducted.
- 115 patients from an acute district general hospital were analyzed.
- Data were collected during weeks 5 and 6 of the UK lockdown.
Main Results:
- Over two-thirds of patients had prior contact with health or social care systems.
- In patients aged 70 and above, this contact rate increased to 85%.
- Shortness of breath or falls were common presentations in the elderly; one-third lacked typical cough or fever.
Conclusions:
- COVID-19 presentation in the elderly can mimic common ailments, leading to missed diagnoses if testing is solely based on cough or fever.
- Vigilance, suspicion, and repeated testing are essential for successful patient stratification and safe service resumption.
- This approach supports the safe restart of elective surgeries and cancer care services.
Objective:
To identify the source of ongoing coronavirus disease 2019 (COVID-19) infections after 4 weeks of lockdown and to characterise the presentation of COVID-19 in the elderly, who represent the highest risk group.
Design:
Retrospective observational cohort study of 115 patients at one acute district general hospital with a catchment population of approximately 500,000 people, during weeks 5 and 6 of the UK lockdown.
Results:
More than 2 in 3 of the overall cohort had had contacts with the health and social care system prior to diagnosis. This figure rose to 85% in those 70 years and over. In the older cohort, the most common reasons for presentation were shortness of breath or falls, and 1 in 3 had neither cough nor fever.
Conclusion:
COVID-19 can present differently in the elderly, overlapping with many common presentations, so focusing testing on those with a cough or fever will miss at least 1 in 3 cases in those over the age of 70. A high degree of vigilance, suspicion and repeated testing is required if streaming into high and low risk areas is to succeed, allowing safe restarting of services such as elective surgery and cancer care.
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