Pathogens, Volume 10, Issue 1 (January 2021) – 85 articles
Cover Story (view full-size image): We describe a COVID-19 outbreak with a high infection and mortality rate among 116 nursing home residents in Rhode Island, USA. While typical symptoms of fever and cough were prevalent, shortness of breath was rarely found despite common hypoxemia. The majority of patients demonstrated atypical symptoms, most common being loss of appetite, lethargy, diarrhea, and fatigue. Mortality was associated with rapid clinical decline beginning with loss of appetite and lethargy and more often involving fever >38 °C, loss of appetite, altered mental status, diarrhea, and respiratory distress. No differences in age or comorbidities were associated with mortality. Treatment with anticoagulation was associated with reduced mortality. Overall, the clinical features of COVID-19 in this population can be subtle and the symptoms commonly atypical. View this paper
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