Atypical clinical presentation of COVID-19 infection in residents of a long-term care facility
- PDF / 579,328 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 36 Downloads / 173 Views
BRIEF REPORT
Atypical clinical presentation of COVID‑19 infection in residents of a long‑term care facility Hubert Blain1 · Yves Rolland2 · Athanase Benetos3 · Nadia Giacosa1 · Mylène Albrand1 · Stéphanie Miot1 · Jean Bousquet4 Received: 19 May 2020 / Accepted: 29 June 2020 © European Geriatric Medicine Society 2020
Key summary points Aim To assess the magnitude of the infection in residents from—and staff working in—a long-term-care facility (LTCF) 7 days after the identification of one resident with confirmed COVID-19 infection and the clinical presentation of the infected residents. Findings Two weeks after the first case, 50.9% of residents and 27.5% of the workers were tested positive for SARS-CoV-2. Diarrhea, fall, delirium, and hypothermia can be initial symptoms of COVID-19 in LTCF residents. Message The rapid dissemination of a COVID-19 infection in a LTCF may be due to a delay in the diagnosis of the first case, whose presentation could be atypical in residents. Abstract Purpose To assess the magnitude of the infection in residents from—and staff working in—a long-term-care facility (LTCF) 7 days after the identification of one resident with confirmed COVID-19 infection and to assess the clinical presentation of the infected residents. Methods All residents and staff members of a LTCF were tested for SARS-CoV-2 by real-time reverse-transcriptase polymerase chain reaction on nasopharyngeal swab. Residents were studied clinically 4 weeks after the first COVID diagnosis. Results Thirty-eight of the 79 residents (48.1%) tested positive for SARS-CoV-2. Respiratory symptoms were preceded by diarrhea (26.3%), a fall (18.4%), fluctuating temperature with hypothermia (34.2%) and delirium in one resident. Respiratory symptoms, including cough and oxygen desaturation, appeared after those initial symptoms or as the first sign in 36.8% and 52.2%, respectively. At any time of the disease, fever was observed in 65.8%. Twelve deaths occurred among the COVID19 residents. Among the 41 residents negative for SARS-CoV-2, symptoms included cough (21.9%), diarrhea (7.3%), fever (21.9%), hypothermia (9.7%), and transient hypoxemia (9.8%). No deaths were observed in this group. 27.5% of the workers were also COVID-19 positive. Conclusion The rapid dissemination of the COVID-19 infection may be explained by the delay in the diagnosis of the first cases due to atypical presentation. Early recognition of symptoms compatible with COVID-19 may help to diagnose COVID-19 residents earlier and test for SARS-CoV-2 symptomatic and asymptomatic staff and residents earlier to implement appropriate infection control practices. Keywords COVID-19 · Testing for SARS-CoV-2 · Long-term-care facility · rRT-PCR * Hubert Blain h‑blain@chu‑montpellier.fr 1
Department of Geriatrics, Centre Antonin Balmes, Pôle de Gérontologie du Centre Hospitalier Universitaire de Montpellier, Montpellier University Hospital, Montpellier University, 39 Avenue Charles Flahault, 34295 Montpellier Cedex 5, France
Gérontopôle de Toulouse, INSERM 1027, 3
Data Loading...
