Comparison of clinical characteristics and outcome measures of PCR-positive and PCR-negative patients diagnosed as COVID-19: Analyses focusing on the older adults.

Senkal N., Bahat G., Medetalibeyoglu A., Cebeci T., Deniz D., Catma Y., ...More

Experimental gerontology, vol.170, pp.111998, 2022 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 170
  • Publication Date: 2022
  • Doi Number: 10.1016/j.exger.2022.111998
  • Journal Name: Experimental gerontology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Abstracts in Social Gerontology, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.111998
  • Keywords: Clinical diagnosis, COVID-19, Elderly, General population, PCR
  • Istanbul University Affiliated: Yes

Abstract

© 2022 Elsevier Inc.Purpose: While the definitive diagnosis of COVID-19 relies on PCR confirmation of the virus, the sensitivity of this technique is limited. The clinicians had to go on with the clinical diagnosis of COVID-19 in selected cases. We aimed to compare PCR-positive and PCR-negative patients diagnosed as COVID-19 with a specific focus on older adults. Methods: We studied 601 hospitalized adults. The demographics, co-morbidities, triage clinical, laboratory characteristics, and outcomes were noted. Differences between the PCR (+) and (−) cases were analyzed. An additional specific analysis focusing on older adults (≥65 years) (n = 184) was performed. Results: The PCR confirmation was present in 359 (59.7 %). There was not any difference in terms of age, sex, travel/contact history, hospitalization duration, ICU need, the time between first symptom/hospitalization to ICU need, ICU days, or survival between PCR-positive and negative cases in the total study group and older adults subgroup. The only symptoms that were different in prevalence between PCR-confirmed and unconfirmed cases were fever (73.3 % vs. 64 %, p = 0.02) and fatigue/myalgia (91.1 % vs. 79.3 %, p = 0.001). Bilateral diffuse pneumonia was also more prevalent in PCR-confirmed cases (20 % vs. 13.3 %, p = 0.03). In older adults, the PCR (−) cases had more prevalent dyspnea (72.2 % vs. 51.4 %, p = 0.004), less prevalent fatigue/myalgia (70.9 % vs. 88.6 %, p = 0.002). Conclusion: The PCR (+) and (−) cases displayed very similar disease phenotypes, courses, and outcomes with few differences between each other. The presence of some worse laboratory findings may indicate a worse immune protective response in PCR (−) cases.