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Coronavirus: “key symptom” of delirium in frail elderly

Older patient in the hospital

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Doctors and caregivers should pay attention to signs of confusion or strange behavior in frail older people because it could be an early warning sign of Covid-1

9, the research suggests.

Even if they don’t have a cough or fever, delirium is more common in vulnerable 65+ than other fitter people of the same age.

But it is still not clear why this extreme confusion or delusion occurs.

The study requires greater awareness of this in hospitals and nursing homes.

The three main symptoms of a Covid infection are a new and continuous cough, a temperature above 37.8 ° C, and a change in smell or taste. About 85% of people will have at least one of these symptoms.

However, research suggests that some age groups may have other symptoms as well, such as diarrhea and vomiting in children.

Symptoms of fragility

In this study from King’s College London, data from over 800 people over the age of 65 were analyzed.

They included 322 hospital patients with Covid-19 and 535 people using the Covid Symptom Study app to record their symptoms or record health reports on behalf of friends and family.

All had received a positive test result.

The researchers found that hospitalized seniors classified as frail were more likely to have had delirium as one of their symptoms, compared to people of the same age who were not frail.

Fragility is used by doctors to describe older people who have difficulty recovering from daily illnesses, strains and accidents. They are also more likely to fall and end up in hospital when they get sick.

For one in five patients hospitalized with Covid, delirium was their only symptom.

‘Changes in mental state’

Among those over 65 using the app, delirium was also more common in more frail people with Covid-19 than in more robust people of the same age with the infection.

For them, possible delirium was defined as having symptoms of confusion, disorientation, or sleepiness.

Fatigue and wheezing were also common among fragile app users.

And one-third of app users who said they experienced delirium didn’t have the classic symptoms of a cough or fever.

“Older and frail people are at a greater risk of Covid-19 than those in better shape, and our results show that delirium is a key symptom in this group,” said Dr Rose Penfold of King’s College London.

“Doctors and caregivers should pay attention to 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.”

The study also highlights the importance of protecting people in nursing homes, where the virus can spread quickly, by making sure hand washing, hygiene and PPE (personal protective equipment) are a priority.

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