RT Journal Article SR Electronic T1 Coronavirus in the elderly: a late lockdown UK cohort JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP e222 OP e228 DO 10.7861/clinmed.2020-0423 VO 20 IS 6 A1 Andrew D Kerr A1 Sybil RL Stacpoole YR 2020 UL http://www.rcpjournals.org/content/20/6/e222.abstract AB Objective To identify the source of ongoing coronavirus disease 2019 (COVID-19) infections after 4 weeks of lockdown and to characterise the presentation of COVID-19 in the elderly, who represent the highest risk group.Design Retrospective observational cohort study of 115 patients at one acute district general hospital with a catchment population of approximately 500,000 people, during weeks 5 and 6 of the UK lockdown.Results More than 2 in 3 of the overall cohort had had contacts with the health and social care system prior to diagnosis. This figure rose to 85% in those 70 years and over. In the older cohort, the most common reasons for presentation were shortness of breath or falls, and 1 in 3 had neither cough nor fever.Conclusion COVID-19 can present differently in the elderly, overlapping with many common presentations, so focusing testing on those with a cough or fever will miss at least 1 in 3 cases in those over the age of 70. A high degree of vigilance, suspicion and repeated testing is required if streaming into high and low risk areas is to succeed, allowing safe restarting of services such as elective surgery and cancer care.