ArticleJournal of the American Geriatrics Society2022
Age-related differences in symptoms in older emergency department patients with COVID-19: Prevalence and outcomes in a multicenter cohort.
Article in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review.BMC geriatrics · 2023Pooled it
- A systematic review and meta-analysis of the effectiveness and safety of COVID-19 vaccination in older adults.Frontiers in immunology · 2023Pooled it
- Behavioral and psychosocial factors associated with coadministration of COVID-19 and influenza vaccines among the elderly.BMC public health · 2026Article
- An electronic patient-reported outcome symptom monitor: the Chinese experience with rapid development of a ready-to-go symptom monitor.BMC public health · 2024Article
- A multi-country analysis of COVID-19 hospitalizations by vaccination status.Med (New York, N.Y.) · 2023Article
- Risk Factors for Long COVID in Older Adults.Biomedicines · 2023Review
- Unraveling Acute and Post-COVID Cytokine Patterns to Anticipate Future Challenges.Journal of clinical medicine · 2023Article
- Performance of point-of-care severity scores to predict prognosis in patients admitted through the emergency department with COVID-19.Journal of hospital medicine · 2023Article
- Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes.European geriatric medicine · 2023Article
- Epidemiology and Clinical Presentation of COVID-19 in Older Adults.Infectious disease clinics of North America · 2023Review
- Analysis of 52 240 source plasma donors of convalescent COVID-19 plasma: Sex, ethnicity, and age association with initial antibody levels and rate of dissipation.Journal of clinical apheresis · 2022Article
- Age-related differences in symptoms in older emergency department patients with COVID-19: Prevalence and outcomes in a multicenter cohort.Journal of the American Geriatrics Society · 2022Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundOlder adults represent a disproportionate share of severe COVID-19 presentations and fatalities, but we have limited understanding of the differences in presentation by age and the association between less typical emergency department (ED) presentations and clinical outcomes.
methodsThis retrospective cohort study used the RECOVER Network registry, a research collaboration of 86 EDs in 27 U.S. states. We focused on encounters with a positive nasopharyngeal swab for SARS-CoV-2, and described their demographics, clinical presentation, and outcomes. Sequential multivariable logistic regressions examined the strength of association between age cohort and outcomes.
resultsOf 4536 encounters, median patient age was 55 years, 49% were women, and 34% were non-Hispanic Black persons. Cough was the most common presenting complaint across age groups (18-64, 65-74, and 75+): 71%, 67%, and 59%, respectively (p < 0.001). Neurological symptoms, particularly altered mental status, were more common in older adults (2%, 11%, 26%; p < 0.001). Patients 75+ had the greatest odds of ED index visit admission of all age groups (adjusted odds ratio [aOR] 6.66; 95% CI 5.23-8.56), 30-day hospitalization (aOR 7.44; 95% CI 5.63-9.99), and severe COVID-19 (aOR 4.26; 95% CI 3.45-5.27). Compared to individuals with alternate presentations and adjusting for age, patients with typical symptoms (fever, cough and/or shortness of breath) had similar odds of ED index visit admission (aOR 1.01; 95% CI 0.81-1.24), potentially higher odds of 30-day hospitalization (aOR 1.23; 95% CI 1.00-1.53), and greater odds of severe COVID-19 (aOR 1.46; 95% CI 1.12-1.90).
conclusionsOlder patients with COVID-19 are more likely to have presentations without the most common symptoms. However, alternate presentations of COVID-19 in older ED patients are not associated with greater odds of mechanical ventilation and/or death. Our data highlights the importance of a liberal COVID-19 testing strategy among older ED patients to facilitate accurate diagnoses and timely treatment and prophylaxis.
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