Features of geriatric status of patients during the pandemic COVID-19

BACKGROUND: In older patients, the new coronavirus infection may present with atypical symptoms such as delirium, dizziness, and unusual fatigue. At the same time, restriction of movement and fear of infection during the COVID-19 pandemic affect decreased physical activity and increased frequency of anxiety, depression and sleep disorders. Due to these symptoms and conditions are significant falls risk factors, the risk of falls and the frequency of falls in older adults is expected to increase in the near future.

AIM: To identify the new cases of COVID-19 infection in patients 65 and older and to determine the incidence and risk factors of falls in patients who have had COVID-19.

MATERIALS AND METHODS: The study involved 86 patients territorially attached to the Family Medicine Center of the North-Western State Medical University named after I.I. Mechnikov. All patients who took part in the study had COVID-19 infection. 48 of them (available at the time of the study) were interviewed in order to establish falls risk factors and cases of falls. The control group consisted of 58 patients who had not had COVID-19 infection. Analysis of the outpatient records of all study participants, screening of frailty, questionnaires, assessment of emotional status, and detection of sleep disorders were performed.

RESULTS: The frequency of neurological symptoms increased in COVID-19 infected patients: dizziness (p < 0.05), unsteady gait (p < 0.05), impaired or lost sense of smell (anosmia) and loss of taste (dysgeusia) (p < 0.05), sleep disorders, symptoms of depression and anxiety. The proportion of patients with decreased body weight was significantly higher after the disease (p = 0.0127). Patients in the control group also had a high frequency of complaints of memory and attention disorders, decreased vision, symptoms of anxiety and depression, and difficulty moving around. The incidence of frailty symptoms in the control group was 63.1% (n = 53). Patients who have not been infected with COVID-19 were significantly more likely to report imbalanced walking 60.3% (n = 35) than patients who had COVID-19 infection 37.5% (n = 18) (p = 0.002). One-third of COVID-19 survivors had elevated plasma glucose levels for the first time, 3.4% had worsened diabetes, and 5.8% of participants were rehospitalized within 3 months of illness.

CONCLUSIONS: The study demonstrated a high incidence of neurological symptoms in participants who had COVID-19: dizziness, unstable gait, sleep disorders, symptoms of depression and anxiety, and weight loss complaints. Patients who had not had COVID-19 infection showed a high frequency of complaints of memory and attention impairment, decreased vision, symptoms of anxiety and depression, and imbalanced walking. The syndromes and symptoms identified in both groups were risk factors for falls and the risk of developing a fear of falling.