| Autor: |
Damanti S; Vita Salute University, 20100 Milan, Italy.; General Medicine and Continuity of Care Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy., Cilla M; Center for Liver Disease, Division of Internal Medicine and Hepatology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Vitali G; General Medicine and Continuity of Care Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy., Tiraferri V; Vita Salute University, 20100 Milan, Italy., Pomaranzi C; Vita Salute University, 20100 Milan, Italy., De Rubertis G; Vita Salute University, 20100 Milan, Italy., De Lorenzo R; Vita Salute University, 20100 Milan, Italy., Di Lucca G; Unit of General Medicine and Advanced Care, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Scotti R; Unit of General Medicine and Advanced Care, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Messina E; Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy., Dell'Acqua R; Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy., Guffanti M; Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy., Cinque P; Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy., Castagna A; Vita Salute University, 20100 Milan, Italy.; Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy., Rovere-Querini P; Vita Salute University, 20100 Milan, Italy.; General Medicine and Continuity of Care Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy.; Division of Immunology, Transplantation & Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Tresoldi M; Unit of General Medicine and Advanced Care, IRCCS Ospedale San Raffaele, 20132 Milan, Italy. |
| Abstrakt: |
Older individuals face an elevated risk of developing geriatric syndromes when confronted with acute stressors like COVID-19. We assessed the connection between in-hospital delirium, malnutrition, and frailty in a cohort of COVID-19 survivors. Patients aged ≥65, hospitalized in a tertiary hospital in Milan for SARS-CoV-2 pneumonia, were enrolled and screened for in-hospital delirium with the 4 'A's Test (4AT) performed twice daily (morning and evening) during hospital stay. Malnutrition was assessed with the malnutrition universal screening tool (MUST) at hospital admission and with the mini-nutritional assessment short-form (MNA-SF) one month after hospital discharge. Frailty was computed with the frailty index one month after hospital discharge. Fifty patients (median age 78.5, 56% male) were enrolled. At hospital admission, 10% were malnourished. The 13 patients (26%) who developed delirium were frailer (7 vs. 4), experienced a higher in-hospital mortality (5 vs. 3), and were more malnourished one month after discharge (3 of the 4 patients with delirium vs. 6 of the 28 patients without delirium who presented at follow up). The 4AT scores correlated with the MNA-SF scores (r = -0.55, p = 0.006) and frailty (r = 0.35, p = 0.001). Frailty also correlated with MUST (r = 0.3, p = 0.04), MNA-SF (r = -0.42, p = 0.02), and hospitalization length (r = 0.44, p = 0.001). Delirium, malnutrition, and frailty are correlated in COVID-19 survivors. Screening for these geriatric syndromes should be incorporated in routine clinical practice. |
