Inpatient mortality was high, especially among the over-80s, who are more likely to present atypically. Despite being older and more frail than those with community-onset infection, their outcomes were no worse. The peak of hospital-onset infections occurred at the same time as the overall peak of admitted infections. Thirty-one (7%) patients acquired COVID-19 having continuously been in hospital for a median of 20 (14, 36) days. Mortality was significantly higher in this group (60% vs 28%, p < 0.001). Cardiac co-morbidity and markers of cardiac dysfunction were more common, but not those of bacterial infection. Patients over 80 presented earlier in their disease course and were significantly less likely to present with the typical features of cough, breathlessness and fever. The ethnic breakdown of patients admitted was similar to that of our underlying local population. Presenting clinical and biochemical features were consistent with those reported elsewhere. The characteristics of all patients, those over 80 years of age and those with hospital-onset COVID-19 were examined. The primary endpoint was death during the index hospital admission. Demographic, clinical and biochemical data were extracted. This was a retrospective cohort study from electronic case records of the first 450 patients admitted to our hospital with PCR-confirmed COVID-19, 77% of the total inpatient caseload to date. There is very limited information on COVID-19 in the over-80s, and the rates of hospital-onset infections are unknown. Data from the UK COVID-19 outbreak are emerging, and there are ongoing concerns about a disproportionate effect on ethnic minorities.
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