Atypical presentation of COVID-19 in a frail older person

Tay, Hui Sian; Harwood, Rowan

Abstract

Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough.We describe a 94-year-old man
with well-controlled schizoaffective disorder, who presented with non-specific and atypical symptoms: delirium, low-grade
pyrexia and abdominal pain. He was given antibiotics for infection of unknown source, subsequently refined to treatment
for community-acquired pneumonia. Despite active treatment, he deteriorated with oxygen desaturation and tachypnoea.
A repeat chest X-ray showed widespread opacification. A postmortem throat swab identified COVID-19 infection. He was
treated in three wards over 5 days with no infection control precautions. This has implications for the screening, assessment
and isolation of frail older people toCOVID-specific clinical facilities and highlights the potential for spread among healthcare professionals and other patients.

Citation

Tay, H. S., & Harwood, R. (2020). Atypical presentation of COVID-19 in a frail older person. Age and Ageing, 49(4), 523-524. https://doi.org/10.1093/ageing/afaa068

• Journal Article Type: Article
• Acceptance Date: Mar 27, 2020
• Online Publication Date: Apr 21, 2020
• Publication Date: Jul 1, 2020
• Deposit Date: Nov 16, 2020
• Publicly Available Date: Apr 22, 2021
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 49
• Issue: 4
• Pages: 523-524
• DOI: https://doi.org/10.1093/ageing/afaa068
• Keywords: Ageing; Geriatrics and Gerontology; General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/4844306
• Publisher URL: https://academic.oup.com/ageing/article/49/4/523/5823067
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record Atypical presentation of COVID-19 in a frail older person; Hui Sian Tay, Rowan Harwood Age and Ageing, Volume 49, Issue 4, July 2020, Pages 523–524 is available online at: https://doi.org/10.1093/ageing/afaa068