Evidence map›Paper›PMID 34209409›Full record

ArticleJournal of clinical medicine2021

Chronology of COVID-19 Symptoms in Very Old Patients: Study of a Hospital Outbreak.

Carmelo Lafuente-Lafuente, Quoc Duy Nghiem, Héloïse Keravec, Sihem Oukbir-Ferrag, Maurizio Magri, Bruno Oquendo, Cristiano Donadio, Antonio Rainone, Joël Belmin

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Carmelo Lafuente-LafuenteService de Gériatrie à Orientation Cardiologique et Neurologique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.ORCID 0000-0002-2475-4670
Quoc Duy NghiemService de Gériatrie à Orientation Cardiologique et Neurologique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.
Héloïse KeravecUnité de Gériatrie Aigue, AP-HP, Sorbonne Université, Hôpital Rothschild, F-75012 Paris, France.
Sihem Oukbir-FerragService de Gériatrie à Orientation Cardiologique et Neurologique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.
Maurizio MagriService de Gériatrie à Orientation Cardiologique et Neurologique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.
Bruno OquendoService de Gériatrie à Orientation Cardiologique et Neurologique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.
Cristiano DonadioService de Gériatrie à Orientation Cardiologique et Neurologique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.
Antonio RainoneService de Soins de Suite et de Réadaptation Gériatrique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.
Joël BelminService de Gériatrie à Orientation Cardiologique et Neurologique, AP-HP, Sorbonne Université, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, F-94200 Ivry-sur-Seine, France.ORCID 0000-0003-1630-9582
Sorbonne Université · FRInserm · FR

Funding

Assistance publique-Hôpitaux de Paris No specific grant numberSorbonne Université No specific grant number
6 · The paper itself

Abstract

backgroundWe wanted to better understand the frequency and temporal distribution of symptoms of COVID-19 in very old patients, which are currently not well defined.

methodsIn an observational, descriptive study, we followed all patients being at three geriatric convalescence and rehabilitation units when a COVID-19 outbreak emerged in those units in March 2020. For those who developed the disease, we recorded any new symptom occurring at diagnosis, in the previous 14 and the following 21 days. A group of SARS-Cov-2-negative patients served as controls.

resultsSixty-nine of the 176 inpatients (mean age: 86 years) were infected by SARS-Cov-2 during the outbreak. At the moment of diagnosis, a majority of patients had fever (71.0%), malaise-asthenia (24.6%), or respiratory symptoms (66.7%). However, 48 patients (69.6% of all SARS-Cov-2 positive patients) also presented, usually several days before, other symptoms: (a) gastrointestinal symptoms (39.1% of all patients, median onset eight days before diagnosis, IQR -9 to +3 days); (b) neurological symptoms (30.4% of all patients, median onset five days before diagnosis, IQR -11 to -3 days), notably delirium (24.6%); and (c) other symptoms, like falls and unexplained decompensation of chronic conditions (29.0% of all patients, median onset four days before diagnosis, IQR -10 to 0). None of those symptoms were observed in similar proportion in 25 control SARS-CoV-2-negative patients, hospitalized during the same period.

conclusionsDiarrhea, nausea-vomiting, delirium, falls, and unexplained decompensation of chronic conditions were the first symptoms of COVID-19 in a majority of older patients in this cohort, preceding typical symptoms by several days. Recognizing those early symptoms could hasten the diagnosis of COVID-19 in this population.

Indexed as

atypical symptomsCOVID-19early diagnosisolder patientstemporal pattern

Identifiers

PMID34209409
PMCPMC8267687
OpenAlexW3173640128

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.