Delirium may be sign of COVID-19 in older patients, research finds

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Delirium, a state of acute confusion associated with a higher risk of serious illness and death, is a key symptom of the novel coronavirus (COVID-19) in frail, older patients, according to a new analysis of data by researchers from King’s College London published in the journal Age and Ageing.

For the study, researchers analyzed data from two groups of older people aged 65 or over from March through May 2020. The first group included 322 patients admitted to hospital with COVID-19 who had tested positive for COVID-19, while the second comprised 535 users of the COVID Symptom Study app who reported having had a positive test result.

The researchers found that older adults admitted to hospital who were classified as frail according to a standard scale were more likely to have had delirium as one of their symptoms than people of the same age who were not classed as frail. Delirium, along with tiredness and breathlessness, were also more common in frailer users of the COVID Symptom Study app with COVID-19, compared with fitter people of the same age.

Additionally, a third of app users experiencing delirium did not report suffering typical COVID-19 symptoms of cough and fever, while delirium was the only symptom for around one in five or 18.9 percent of hospitalized patients, according to the study.

Frailty in the group of hospitalized patients was measured using the Clinical Frailty Scale (CFS) test, which is administered by a doctor. The researchers said app users were asked to complete a short questionnaire asking about their health, which is comparable to the CFS.

The findings suggest practitioners should be aware of delirium as a possible early warning sign of COVID-19 in the elderly, even in the absence of more typical symptoms such as cough or fever, the researchers said.

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