Background: Multiple neurocognitive manifestations of COVID-19 have been reported. Symptomatic patients with COVID-19 typically present with respiratory symptoms but neurocognitive symptoms are common, especially in geriatric hospitalized patients with severe infection.
Objective: To determine the prevalence and clinical impact of neurocognitive symptoms on the outcome of COVID-19 in geriatric patients.
Patients and methods: A retrospective observational study conducted in Ain-Shams University Geriatrics hospital for isolation of COVID-19 patients. Number of included patients was 233 patients with positive Reverse Transcription Polymerase Chain Reaction (RT-PCR) results for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2) infection. Length of stay was determined and mortality was the primary clinical outcome. Statistical analyses were performed.
Results: We found that 54% of the studied cases had neurocognitive manifestations. Delirium and decline in consciousness levels were higher in deceased patients with statistically significant differences. There was a significant difference between alive and deceased groups regarding the presence of either neurocognitive or respiratory symptoms. A higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score was significantly associated with a higher mortality rate. There were significant differences regarding TLC, serum sodium, Blood Urea Nitrogen (BUN), creatinine, albumin, C - C-reactive protein (CRP), Ferritin, and D-Dimer. Upon regression analysis, a higher APACHE II score was an independent risk factor for mortality.
Conclusion: Neurocognitive manifestations were common among hospitalized geriatric patients with COVID-19 and were associated with poor hospital outcomes. Accordingly, these manifestations should be taken seriously and should receive early interventions to prevent undesirable events.