Late Breaking Abstract - Atypical clinical and radiological presentation of SARS-CoV-2 infection in the elderly

Abstract

<b>Objectives:</b> We sought to evaluate the association between age and presentation of SARS-COV2 infection. <b>Methods:</b> Clinical presentation and radiological data of all consecutive COVID19 patients admitted to our Hospital between 01-03-2020 and 30-04-2020 were analyzed. SARS-CoV-2 positive patients were diagnosed by either swab test or bronchoalveolar lavage. Patients without proved SARS-CoV-2 infection or without HRCT scan were excluded. All HRCT were reviewed and classified according to RSNA Classification of SARS-CoV-2 pneumonia(1). <b>Results:</b> Over the study period, 179 patients met the inclusion criteria. Mean age was 67 years (SD 15.1, range 19-96); 55.8% (N= 100) were male. Of them, 22 patients (12%) had atypical clinical presentation. The more frequent atypical presentations were cardiovascular, including syncope (N= 5, 22%) and heart failure (N= 5, 22%). HRCT was Typical in 151 (84.4%) patients, Indeterminate in 14 (7.8%), Atypical in 12 (6.7%), and Negative in 2 (0.01%). Among elderly patients (≥70 years old) accounting for 44% of the total population (N=80), HRTC was more frequently Atypical (11/80 patients, 13.75%) compared to younger patients (&lt;70 year of age, 1/99 patients, 1%) (p-value= 0.001). Similarly, the clinical presentation was more frequently atypical in the elderly (19/80, 23%) compared to the younger (3/99, 3.0%) (p-value &lt;0.0001). <b>Conclusions:</b> Our study demonstrated that SARS-CoV-2 infections in elderly can results in atypical clinical and radiological presentation, potentially leading to misdiagnosis and unrecognized cases. (1)Simpson S, et al. Radiology. 2020. doi: 10.1148/ryct.2020200152.