Confusion ‘is a major symptom of Covid-19 in frail older people’


The sudden feeling of confusion and delirium is a common symptom of Covid-19 in frail older people, scientists have found.

UK officials don’t recognize any symptoms other than a cough, fever and a lost sense of taste or smell, but there are many others that people regularly experience.

Experts running King’s College London’s Covid Symptom Tracker app have now found that a large proportion of the elderly get delirious when they are sick.

Delirium is a state that comes on suddenly in which people become confused, have trouble thinking clearly and can hallucinate, become agitated or have mood swings.

The condition is caused by problems in the brain and can make people more likely to become seriously ill or die in hospital, as their bodies generally become weaker and less able to recover, and the effects on the brain can be long-lasting or permanent .

Using self-reported symptoms of about 850 people over 65, the King’s researchers found that people who were officially considered “ vulnerable ” were three times as likely to become delirious.

And of those over 65 who ended up in the hospital because of Covid-19, one in five (18.9 percent) said delirium was their only symptom.

The researchers said the coronavirus could potentially get into the brain and infect it, affecting a person’s mental state. And delirium can also be caused by high levels of white blood cells in the brain or by fever, a separate symptom of Covid-19.

Vulnerable people - the elderly and those with long-term illnesses - are most likely to die from Covid-19 if they get it, so understanding how it affects them, scientists say (photo: an elderly woman with Covid -19 in Italy in April)

Vulnerable people – the elderly and those with long-term illnesses – are most likely to die from Covid-19 if they get it, so understanding how it affects them, scientists say (photo: an elderly woman with Covid -19 in Italy in April)

This chart, based on a study by Public Health England, shows which symptoms are most common in people with Covid-19 and how they relate to signs of the common cold and flu.

This chart, based on a study by Public Health England, shows which symptoms are most common in people with Covid-19 and how they relate to signs of the common cold and flu.

This chart, based on a study by Public Health England, shows which symptoms are most common in people with Covid-19 and how they relate to signs of the common cold and flu.

Dr. Rose Penfold, an epidemiologist at King’s, said, “Older, frail people are at greater risk for Covid-19 than those who are fitter, and our results show that delirium is a major symptom in this group.

“Doctors and carers should watch for changes in mental status in the elderly, such as confusion or strange behavior, and be aware that this may be an early sign of a coronavirus infection.”

While delirium can cause similar symptoms to dementia or just age-related brain decline, it usually comes on quickly and makes a noticeable difference.

It can happen in people who are otherwise mentally healthy, or make problems worse in people who already have them.

The team looked at data from 322 elderly people who were hospitalized with coronavirus between March and May, as well as 535 people who tested positive and used the Covid Symptom Tracker app over the same time period.

WHAT ARE THE REAL SYMPTOMS OF CORONAVIRUS?

UK authorities recognize only three major symptoms of Covid-19: a new cough, fever, or a lost or altered sense of taste or smell.

Cough and fever have been at the top of the list since the virus was discovered, as they are the most common symptoms in people who become seriously ill and end up in hospital.

The lost or altered sense of smell was added to the list in May after months of yelling from nose and throat doctors. This was only added because it was so specific – people don’t often experience it from other common illnesses.

However, Britain’s list of symptoms is far from exhaustive.

Officials have been criticized for not including a wider range of symptoms known to be caused by Covid-19.

For example, the Centers for Disease Control and Prevention in the US lists 11 symptoms and admits that these aren’t even all. The ones used in the US are:

  • Fever or chills
  • Cough
  • Shortness of breath or breathing difficulties
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Other less common symptoms include ‘covid toe’, where the feet become discolored or develop lesions, or eye problems that cause people’s eyes to swell or water excessively.

A study in Northern Ireland found that intestinal problems, including diarrhea and vomiting, were a more accurate predictor of Covid-19 in children than cough.

But authorities must choose the symptoms by treading a line between the symptoms that are almost always present in Covid-19 and those caused by the coronavirus, but more often by something else.

For example, the majority of people with diarrhea or fatigue are more likely to have a stomach injury or a cold than the coronavirus, meaning testing them all for Covid-19 would be a waste of time and money.

App users can report the symptoms of a friend or family member, which means the delirious people didn’t have to report for themselves in all cases.

In addition to the symptoms those over 65 reported – or had reported for them – the scientists looked at how vulnerable they were.

This was done with the help of a questionnaire for the app users or came from a standardized assessment of a doctor for patients who were in the hospital.

People who are considered vulnerable can be those who are physically weak, disabled, in poor health, or have brain damage, such as those caused by dementia.

Most people who live in nursing homes are considered vulnerable, and they are also the group most at risk of dying if they contract the coronavirus, making it important to understand the most common symptoms in that group.

Vulnerable people with Covid-19 were more likely to experience delirium, fatigue, and shortness of breath than those who were the same age but stronger, the study found.

One-third of people who reported having delirium on the app said they didn’t have the classic Covid-19 symptoms of cough and fever.

Of the vulnerable patients, 38 percent had delirium, compared to only 12 percent of the non-vulnerable patients in the same age group, meaning it was three times more common.

The study found that there were no significant differences in the frequency of other common symptoms, such as cough or fever, between vulnerable and non-vulnerable groups.

Dr. Claire Steves, a London geriatrician and teacher at King’s College, said: “The past six months have shown us that Covid-19 can spread catastrophically through nursing homes.

Knowing that delirium is a symptom in the frail, older people will help families and caregivers to spot the signs of Covid-19 sooner and act appropriately and put in place infection control measures such as isolation, increased hygiene and personal protective equipment to prevent this very much. vulnerable group. group.’

The study, published in the journal Age and aging, adds to emerging evidence that the symptoms people experience when they contract the coronavirus vary with age.

While middle-aged and older people – the group most likely to be hospitalized – often have a cough or fever, others have them less often.

Young adults often appear to have no symptoms at all or have only a mild flu-like illness.

And a study conducted in Northern Ireland found that children often don’t have symptoms, but among those who did, vomiting, diarrhea, and abdominal pain were some of the most common.

They said that coughing was much less common in children with the disease and that problems with the gut were a stronger indicator of whether or not coronavirus was.

Dr. Tom Waterfield of Queen’s University Belfast told the BBC: ‘We find that diarrhea and vomiting are a symptom reported by some children and I think it’s worth adding to the list of known symptoms.’

Dr. Waterfield and colleagues studied 992 children, 68 of whom had the coronavirus. They were on average 10 years old.

Counting gastrointestinal symptoms – those affecting the stomach and intestines – would have significantly improved how many of the children could be diagnosed.

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