Olde Rikkert M G M, Vingerhoets R W, van Geldorp N, de Jong E, Maas H A A M
Radboudumc, afd. Geriatrie, Nijmegen.
Contact: M. G.M. Olde Rikkert (
Ned Tijdschr Geneeskd. 2020 Apr 8;164:D5004.
Clinical characteristics and outcomes among older patients with a SARS-CoV-2 infection differ greatly from those seen in younger patients. Here we highlight atypical presentations of this fulminant infectious disease COVID-19, based on a clinical case and a cohort of 19 patients admitted to a geriatric ward. The degree of frailty, resilience and number of co-morbidities caused COVID-19 to present as acute geriatric syndrome events such as falls, delirium and dehydration in these patients. Clinical laboratory results considered typical for COVID-19 were present less often in this frail older population. As in other countries, morbidity and mortality is most severe among frail male patients; therefore, assessment of changes suggestive of typical acute geriatric syndromes in frail older patients with chronic diseases should lead to a careful clinical examination for a SARS-CoV-2 infection. Protocols for diagnosis, and contact isolation measures, should take these atypical presentations into account.
新型冠状病毒肺炎（SARS-CoV-2）感染老年患者的临床特征和转归与年轻患者有很大差异。在此，我们基于1例临床病例及入住老年病房的19例患者队列，重点介绍这种暴发性传染病——新型冠状病毒肺炎（COVID-19）的非典型表现。在这些患者中，虚弱程度、恢复力及共病数量致使COVID-19表现为急性老年综合征事件，如跌倒、谵妄和脱水。在这个虚弱的老年人群中，被认为是COVID-19典型表现的临床实验室检查结果出现的频率较低。与其他国家一样，虚弱男性患者的发病率和死亡率最为严重；因此，对患有慢性疾病的虚弱老年患者中提示典型急性老年综合征的变化进行评估，应促使医生对SARS-CoV-2感染进行仔细的临床检查。诊断方案及接触隔离措施应考虑到这些非典型表现。
