Abstract
The objective of this national French survey was to determine the coronavirus disease 2019 (COVID-19) semiology in seniors (n = 353; mean, 84.7 ± 7.0 years). A total of 57.8% of patients exhibited ≤3 symptoms, including thermal dysregulation (83.6%), cough (58.9%), asthenia (52.7%), polypnea (39.9%), and gastrointestinal signs (24.4%). Patients ≥80 years exhibited falls (P = .002) and asthenia (P = .002). Patients with neurocognitive disorders exhibited delirium (P < .001) and altered consciousness (P = .001). Clinical peculiarities of COVID-19 were reported in seniors.Clinical Trials RegistrationNCT04343781.
Highlights
The second profile matched with patients aged 80 years and older with MND; the latter exhibiting more frequently no specific symptoms, and most often an absence of hyperthermia, polypnea, cough, and dysgeusia-ageusia. This national French survey shows that older adults with COVID-19 exhibit a pauci-symptomatic clinical picture with less than 3 signs during the first 72 hours of the infection, generally combining general and respiratory signs
Compared with previous meta-analyses in younger adults [5,6,7], we found that older adults with COVID-19 often exhibit thermal dysregulation, which, results less often in hyperthermia (56% here vs 82% [5] to 91% [6] in younger adults) and more often in subfebrile temperatures or alternations of hyperthermia and hypothermia
Older adults exhibited more often dyspnea (40% here vs 26% [5] to 30% [6] in younger adults) and gastrointestinal signs (24.4% here with mostly diarrhea [21.8%] vs 10% in younger adults [5, 8]). This should encourage clinicians to integrate the gastrointestinal signs into the diagnostic reasoning for SARS-CoV-2 infection in older adults
Summary
The following symptoms observed within the first 72 hours of SARS-CoV-2 infection (ie, 72 hours from suspicion, possibly before diagnostic confirmation by RT-PCR test) were collected for each patient using yes/no questions: general signs (sudden deterioration of general condition, temperature, blood pressure), respiratory signs (cough, polypnea), ear nose and throat signs (rhinorrhea, odynophagia, otalgia, conjunctivitis, dysgeusia or ageusia, anosmia), gastrointestinal signs (diarrhea, nausea, vomiting) and geriatric syndromes (falls, hypo- or overactive delirium, altered consciousness). The profiles of COVID-19 patients were determined according to their symptoms, age, and history of MND using a multiple correspondence analysis.
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