A Unique Presentation of Delirium in a Patient with Otherwise Asymptomatic COVID ‐19
Open accessAbstract
OBJECTIVE: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), manifests with a wide spectrum of presentations. Most reports of COVID-19 highlight fever and upper respiratory symptoms as the dominant initial presentations, consistent with the World Health Organization guidelines regarding suspected SARS-CoV-2 infection. However, atypical presentations of this disease have been evolving since the initial outbreak of the pandemic in December 2019. We report a case of an older male patient who presented at our hospital with an unusual manifestation of COVID-19. DESIGN: Brief report. SETTING: A university hospital in Saudi Arabia. PARTICIPANT: A 73-year-old man who presented with confusion in the absence of any respiratory symptoms or fever. INTERVENTION: The patient was initially admitted with delirium and underwent a further work-up. MEASUREMENTS: Given his recent history of domestic travel and the declaration of a global COVID-19 pandemic status, the patient was administered a swab test for SARS-CoV-2. RESULTS: The patient's positive test led to a diagnosis of COVID-19. Although he began to experience a spiking fever and mild upper respiratory symptoms, he recovered rapidly with no residual sequela. CONCLUSION: The recognition of atypical presentations of COVID-19 infection, such as delirium, is critical to the timely diagnosis, provision of appropriate care, and avoidance of outbreaks within healthcare facilities during this pandemic. J Am Geriatr Soc 68:1382-1384, 2020.
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In both studies on older adults without dementia with acute COVID-19, assessment of neuropsychiatric symptoms was based on a clinician's judgment, and no use of standardised tools was reported.
“In both studies, assessment of neuropsychiatric symptoms was based on a clinician's judgment, and no use of standardised tools was reported.”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [13]
Alkeridy et al. described a 73-year-old man without dementia who tested positive for COVID-19 and presented exclusively with delirium at onset, in the absence of common COVID-19 symptoms.
“Alkeridy et al. (13) described the single case of a 73-year-old man without dementia who resulted positive to testing for COVID-19. The authors observed that this patient presented exclusively with delirium at onset, in the absence of the most common symptoms observed in people infected with COVID-19”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [13]
Delirium is the most common behavioural symptom recorded at the peak of COVID-19 infection, and even at onset, in the absence of any other symptoms, especially in patients with dementia.
“The evidence we have reviewed in the current manuscript is limited to a small number of studies that converge towards delirium being the most common behavioural symptom recorded at the peak of the infection, and even at onset, in the absence of any other symptoms (13), especially in patients with dementia (17).”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [13]
Cites
Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., Ren, R., Leung, K. S. M., Lau, E. H. Y., Wong, J. Y., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001316 · Cited by 16,575 · see citing works
Fair Allocation of Scarce Medical Resources in the Time of Covid-19
Emanuel, E., Persad, G., Upshur, R. E. G., Thome, B. D. C., Parker, M., Glickman, A., Zhang, C., Boyle, C., Smith, M. J., & Phillips, J. P. (2020) · New England Journal of Medicine · doi:10.1056/nejmsb2005114 · Cited by 3,143 · see citing works
Coronavirus Infections—More Than Just the Common Cold
Paules, C. I., Marston, H. D., & Fauci, A. S. (2020) · JAMA · doi:10.1001/jama.2020.0757 · Cited by 2,135 · see citing works
COVID-19: towards controlling of a pandemic
Bedford, J., Enria, D., Giesecke, J., Heymann, D. L., Ihekweazu, C., Kobinger, G., Lane, H. C., Memish, Z., Oh, M.-D., Sall, A. A., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30673-5 · Cited by 1,545 · see citing works
COVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: Imaging Features
Poyiadji, N., Shahin, G., Noujaim, D., Stone, M., Patel, S., & Griffith, B. (2020) · Radiology · doi:10.1148/radiol.2020201187 · Cited by 1,505 · see citing works
Mao, L., Wang, M., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Hu, Y., et al. (2020) · medRxiv · doi:10.1101/2020.02.22.20026500 · Cited by 882 · see citing works
Aiello, A., Farzaneh, F., Candore, G., Caruso, C., Davinelli, S., Gambino, C. M., Ligotti, M. E., Zareian, N., & Accardi, G. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.02247 · Cited by 693 · see citing works
Mao, L., Wang, M., Chen, S., et al. (2020) · SSRN Electronic Journal · doi:10.2139/ssrn.3544840 · Cited by 323 · see citing works
Sars-Cov-2: Underestimated damage to nervous system
Zhou, L., Zhang, M., Wang, J., & Gao, J. (2020) · Travel Medicine and Infectious Disease · doi:10.1016/j.tmaid.2020.101642 · Cited by 280 · see citing works
Diagnostic Testing for the Novel Coronavirus
Sharfstein, J. M., Becker, S. J., & Mello, M. M. (2020) · JAMA · doi:10.1001/jama.2020.3864 · Cited by 232 · see citing works
Illness Presentation in Elderly Patients
Jarrett, P. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.1995.00430100086010 · Cited by 225 · see citing works
Tuite, A. R., Bogoch, I. I., Sherbo, R., Watts, A., Fisman, D. N., & Khan, K. (2020) · Annals of Internal Medicine · doi:10.7326/m20-0696 · Cited by 186 · see citing works
Atypical presentations of SARS
Fisher, D. A., Lim, T.-K., Lim, Y.-T., et al. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13336-3 · Cited by 53 · see citing works
Thermoregulatory Failure in the Elderly
Wongsurawat, N., Davis, B. B., & Morley, J. E. (1990) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1990.tb05708.x · Cited by 28 · see citing works
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Manca, R., De Marco, M., & Venneri, A. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.585540 · Cited by 227 · see citing works
- Authors
- Alkeridy, W. A., Almaghlouth, I., Alrashed, R., Alayed, K., Binkhamis, K., Alsharidi, A., & Liu‐Ambrose, T.
- Affiliations
- University of British Columbia (CA)
- King Saud University (SA)
- Department of Medicine King Saud University Riyadh Saudi Arabia
- Department of Physical Therapy, Aging, Mobility, and Cognitive Neuroscience Laboratory, Faculty of Medicine University of British Columbia Vancouver Canada
- Corresponding author
- Alkeridy, Walid A.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2020-05-16
- Volume
- 68
- Issue
- 7
- Pages
- 1382-1384
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC7272789
- OpenAlex
- W3023390253
- Cited by
- 70
- References
- 14
- Citations by year
- 2024: 3 · 2023: 5 · 2022: 12 · 2021: 23 · 2020: 27
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Dermatology › Dermatological and COVID-19 studies
- Keywords
- COVID-19 pandemic, SARS-CoV-2, delirium, atypical presentation, confusion, older adults, febrile illness, upper respiratory symptoms, travel-associated infection
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Aged, Delirium, Humans, Male, Pneumonia, Viral, Coronavirus Infections, Asymptomatic Infections, Pandemics
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