Differences in symptoms and utility of MEWS score in geriatric patients with COVID-19

Abstract

Introduction: Rational resource management was key to avoiding overcrowding in Coronavirus Infectious Disease 2019 (COVID-19) dedicated wards. The study aimed to identify specific symptoms for aged patients with COVID-19 and assess the utility of the Modified Early Warning Score (MEWS) as a tool that may support decisions within an emergency department (ED). Material and methods: This was a retrospective analysis of medical records. ED patients with positive antigen tests for COVID-19 infection were identified. Patients’ history, length of stay (LOS) and vital signs were collected. MEWS score was calculated. Age groups were divided as follows: non-geriatric (NG) — aged under 60; geriatric groups (G): G1 — aged 60–74; G2 — aged 75–89; G3 — aged 90 and over. Results: There were 777 individuals (261 NG and 510 G patients). Symptoms related to pain as well as anosmia and ageusia occurred more often in NG patients. The longest LOS was in G2 — 182 [101–295] minutes. A significantly shorter LOS (51 [24–156] minutes) was recorded in NG (NG vs. G1 p < 0.0001; NG vs. G2 p < 0.0001; NG vs. G3 p = 0.0007). Admission rate was as follow: NG: 17.24%, G1: 50.97%, G2: 61.43%, G3: 54.17. Accuracy parameters for MEWS score (NG vs G, [%]) were as follow: sensitivity (93.18 vs. 91.04), specificity (13.04 vs. 11.79), positive predictive value (18.55 vs. 52.88), negative predictive value (90.00 vs. 54.76). Conclusions: Geriatric patients spent more time in ED and were admitted more often. Seniors were less likely to experience pain. MEWS is not a valuable tool for supporting decisions concerning the admission or discharge of geriatric patients with COVID-19.