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A new analysis of data from researchers at King’s College London using information from the COVID Symptom Study app and patients admitted to St Thomas’ Hospital in London, has shown that delirium, an acutely confused state associated with an increased risk of severe illness and death – a key symptom of COVID-19 in frail older people
The findings, published in the journal Age and aging, highlight that physicians and caregivers should be aware of delirium as a possible early warning sign of COVID-19 in the elderly, even in the absence of more typical symptoms such as cough or fever.
Led by Dr. Rose Penfold, a clinical fellow and geriatrician at King’s College London, the researchers analyzed data from two groups of people aged 65 and over from March to May. The first group included 322 patients admitted to the hospital with COVID-19 who had tested positive for COVID-19, while the second consisted of 535 users of the COVID Symptom Study app who reported having a positive result in the proof.
They found that older adults admitted to the hospital who were classified as frail according to a standard scale were more likely to have had delirium as one of their symptoms than people of the same age who were not classified as frail. Delirium, along with tiredness and shortness of breath, were also more common in more frail users of the COVID Symptom Study app with COVID-19, compared to fitter people the same age.
A third of the app users who experienced delirium did not report experiencing the ‘classic’ symptoms of COVID-19 cough and fever, while delirium was the sole symptom for around one in five (18.9%) of hospitalized patients.
Frailty in the group of hospitalized patients was measured using the Clinical Frailty Scale (CFS) test, which is administered by a physician. Users of the COVID symptom study app were asked to complete a short questionnaire asking about their health, which is comparable to CFS.
This is the first study to show that delirium is a likely symptom of COVID-19 in frail older adults, although the precise biological connection between the two conditions has yet to be understood. The findings also highlight the need for systematic frailty assessment for older people, along with awareness and delirium detection for this vulnerable population in hospitals, nursing homes, and the community.
Dr Rose Penfold from King’s College London said: “Older and more frail people are at higher risk of COVID-19 than those who are more fit, and our results show that delirium is a key symptom in Physicians and caregivers should beware of any changes in mental status in older people, such as confusion or strange behavior, and be alert to the fact that this could be an early sign of coronavirus infection. “
Dr Claire Steves, King’s College London, said: “The last six months have shown us that COVID-19 can spread catastrophically through nursing homes. Knowing that delirium is a symptom in older people Fragiles will help families and caregivers detect the signs of COVID-19 earlier and act appropriately and implement infection control measures such as isolation, improved hygiene and personal protective equipment to protect this highly vulnerable group. ” .
Professor Tim Spector, Professor of Genetic Epidemiology at King’s College London and COVID Symptom Study Leader, said: “In April we updated the COVID Symptom Study app to allow users to record health reports on behalf of of friends and family who cannot access the app. This significantly increased the number of older people in the study, providing vital information. We are very grateful to all of our users and urge everyone to download the app and record their health and that of their loved ones daily as we move into the winter months. “
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Materials provided by King’s College London. Note: Content can be edited for style and length.
