COVID-19: Possible Symptoms of Seniors infected
COVID-19: Possible Symptoms of Seniors infected. Consciousness and nonsense in the elderly may be manifestations of COVID-19 pneumonia. The Journal of the American Medical Association (JAMA) published an article suggesting that, in addition to common symptoms such as fever and cough, delirium ranks sixth among all patients with COVID-19 pneumonia. Elderly patients with COVID-19 pneumonia who are treated with delirium symptoms are more likely to become severely ill and require early treatment.
Study author Maura Kennedy, a physician in the emergency department of Massachusetts General Hospital, said that COVID-19 pneumonia poses a safety risk to people of all ages, and it is particularly dangerous to people over 65. Statistics show that 65-year-olds in the United States account for about 16% of the total population, but the death toll is more than 80% of the total. Due to differences in the immune system after infection, some elderly patients with COVID-19 pneumonia did not show flu-like symptoms such as fever and cough when they saw the doctor, which may delay diagnosis and treatment.
Kennedy said that delirium is one of the most common symptoms of elderly patients admitted to the emergency department, including changes in the level of consciousness, nonsense, disorientation, inattention and other cognitive impairments. We have found through reading other reports that COVID-19 pneumonia infection can cause delirium, then delirium may be one of the important manifestations of COVID-19 pneumonia in the elderly.
The researchers collected the medical records of 817 elderly patients with COVID-19 pneumonia. 28% of them had symptoms of delirium at the time of medical consultation. Compared with fever (56%), shortness of breath (51%), cough (50%), and hypoxia (40%) %) and frailty (30%) ranked sixth, with a total of 226 patients. Among the two hundred patients, 16% had delirium as the main symptom, and 37% had no typical fever and cough symptoms.
Delirium is also related to the severity of the disease. Previous studies have shown that the rate of delirium in hospitalized patients with COVID-19 pneumonia is about 25% to 33%, while that of patients treated in ICU is 65%.
Kennedy said that the probability of fever symptoms in patients with COVID-19 pneumonia is about 80%, so we often use fever as the main method of identification. However, due to physiological changes caused by body aging, such as lower basal body temperature in the elderly and impaired febrile response ability under acute infection conditions, the proportion of fever among elderly patients is only 56%. Many patients’ families and even family doctors are not aware of the seriousness of delirium, or refuse to let the elderly go to the higher-level hospital for fear of cross-infection, leading to delay in diagnosis and treatment. We suggest that clinicians should be alert to the symptoms of delirium in the elderly, regardless of whether they have other typical symptoms, they should be screened for COVID-19 pneumonia to avoid missed diagnosis and prevent the risk of becoming severe or even death.
At present, the US CDC guidelines mention that delirium is a “warning sign” of COVID-19 pneumonia, rather than a symptom, which may cause a large number of cases to be missed or delayed. Our research provides reliable evidence that we should consider delirium in the elderly as an important symptom of COVID-19 pneumonia. Patients with such symptoms need to be screened and tested first, so that patients can be diagnosed as soon as possible and reduce the risk of severe illness and death .