Abstract
Clinical and prognostic differences between symptomatic and asymptomatic older patients with COVID-19 are of great interest since frail patients often show atypical presentation of illness. Lung Ultrasound (LUS) has been proven to be a reliable tool for detecting early-phase COVID-19 pneumonic alterations. The current prospective bicentric study aimed to compare LUS score and 3-month overall mortality between asymptomatic and symptomatic older patients with COVID-19, according to frailty status. Patients were stratified according to LUS score tertiles and Clinical Frailty Scale categories. Survival rate was assessed by telephone interviews 3 months after discharge. 64 symptomatic (24 women, aged 80.0 ± 10.8 years) and 46 asymptomatic (31 women, aged 84.3 ± 8.8 years) were consecutively enrolled. LUS score resulted an independent predictor of 3-month mortality [OR 2.27 (CI95% 1.09–4.8), p = 0.03], and the highest mortality rate was observed in symptomatic and asymptomatic pre-frail and frail patients (70.6% and 66.7%, respectively) with greater LUS abnormalities (3rd tertile). In conclusion, LUS identified an acute interstitial lung involvement in most of the older asymptomatic patients. Mortality rate progressively increased according to clinical frailty and LUS score degree, resulting a reliable prognostic tool in both symptomatic and asymptomatic patients.
Highlights
Clinical and prognostic differences between symptomatic and asymptomatic older patients with COVID-19 are of great interest since frail patients often show atypical presentation of illness
Severe Acute Respiratory Syndrome caused by Coronavirus, etiological agent of COVID-19 associated pneumonia, has been identified all over the world since, in December 2019, SARS-CoV-2 has been isolated in China for the first time[1]
Clinical status of older patients with asymptomatic COVID-19 is of great interest, since frail patients often show nontypical COVID-19 clinical presentation; in a retrospective study by Bianchetti et al.[6] regarding older patients with dementia, classical COVID-19 symptoms as dyspnoea or fever were recorded at Emergency Department (ED) admission in less than one half inpatients
Summary
Clinical and prognostic differences between symptomatic and asymptomatic older patients with COVID-19 are of great interest since frail patients often show atypical presentation of illness. The current prospective bicentric study aimed to compare LUS score and 3-month overall mortality between asymptomatic and symptomatic older patients with COVID-19, according to frailty status. Mortality rate progressively increased according to clinical frailty and LUS score degree, resulting a reliable prognostic tool in both symptomatic and asymptomatic patients. A recent study by Rutten et al.[9] reported that, despite symptomatology overlapped between nursing-home residents with and without COVID19, those with COVID-19 were 3 times more likely to die within 30 days For these reasons, early detection of the severity of pulmonary involvement is crucial in older patients with COVID-19 diagnosis, regardless their clinical presentation. Secondary endpoint is to assess the possible relationship between LUS score and short-term mortality rate in symptomatic and asymptomatic patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
