Resumen
Introducción: la neumonía causada por el SARS-CoV-2 es un problema de salud pública. Los adultos mayores son vulnerables y la forma de presentación atípica retarda el diagnóstico y aumenta la mortalidad. En este grupo las manifestaciones clínicas atípicas son más frecuentes.
Objetivo: identificar las manifestaciones clínicas y la mortalidad de la neumonía por COVID-19 en adultos mayores hospitalizados.
Material y métodos: estudio observacional transversal comparativo, realizado del 1 de julio del 2020 al 31 de diciembre del 2021 en un hospital general de la Ciudad de México. Se incluyeron pacientes de 60 años o más que fueron hospitalizados con diagnóstico de COVID-19.
Resultados: participaron 267 adultos mayores; el 53.9% fueron hombres, con una mediana de 74 años. Las comorbilidades más frecuentes en esta población fueron diabetes mellitus 2 (DM2), hipertensión arterial sistémica (HAS) y enfermedad pulmonar obstructiva crónica (EPOC). El 41.2% mostró presentación atípica de la enfermedad; la mortalidad en la población estudiada fue de 53.5%.
Conclusiones: la presentación atípica de la neumonía por COVID-19 es común en los adultos mayores de 60 años y se incrementa significativamente a medida que son más longevos. La ausencia de sintomatología típica de neumonía y el desconocimiento de la presentación más habitual podría retrasar el diagnóstico y la atención oportuna en este grupo etario, lo cual podría incrementar las complicaciones y la mortalidad.
Abstract
Background: Pneumonia caused by SARS-CoV-2 is a public health problem. Older adults are vulnerable and the atypical presentation delays diagnosis and increases mortality. In this group the atypical clinical manifestations are more frequent.
Objective: To identify the clinical manifestations and mortality of COVID-19 pneumonia in hospitalized older adults.
Material and methods: A comparative cross-sectional observational study was carried out, from July 1, 2020, to December 31, 2021, in a general hospital of Mexico City. Patients aged 60 years or more who were hospitalized with a diagnosis of COVID-19 were included.
Results: 267 older adults participated; 53.9% were men, with a median age of 74 years. The most frequent comorbidities in this population were type 2 diabetes mellitus (T2DM), hypertension and chronic obstructive pulmonary disease (COPD). 41.2% showed atypical presentation of the disease; mortality in the studied population was 53.5%.
Conclusions: The atypical presentation of COVID-19 pneumonia is common in adults over 60 years of age and it increases significantly as they become older. The absence of typical symptoms of pneumonia and the ignorance of the most common signs could delay diagnosis and timely care in this age group, which may increase complications and mortality.
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