Burnout in healthcare workers in COVID-19-dedicated hospitals.

BACKGROUND: Considering the prolongation of the COVID-19 pandemic, the lack of studies on burnout, particularly in healthcare workers, needs to be addressed. This report aimed to identify the risk factors of burnout by comparing the level of burnout between nurses in general wards and those in COVID-19-dedicated wards in a national university hospital. METHODS: A survey based on the Korean version of Burnout Assessment Tool (BAT-K) was conducted on nurses between 10 January and 31 January 2022. The BAT-K consists of exhaustion, mental distance, cognitive impairment, emotional impairment and secondary symptoms. RESULTS: A total of 165 nurses, including 81 nurses from the COVID-19-dedicated ward, completed the questionnaire. The percentage of general-ward nurses with an emotional impairment score above the clinical cutoff was higher than that of COVID-19 ward nurses. General ward compared to the COVID-19 ward increased the risk of presenting with total-core symptoms. Two factors increased the risk regarding mental distance: short career length and underlying disease. CONCLUSIONS: In contrast to previous studies, the risk of burnout in the COVID-19-ward nurses was lower than that of the general ward nurses. The risk regarding mental distance was correlated with short career length and presence of an underlying disease.

Ethics, rigour and agility of research and evaluation methods in a changing social and clinical context: Reflections from a psychosocial research centre on the implications of the COVID-19 pandemic

The Centre for Psychosocial Research in Cancer conducts world-leading research and service evaluations to support well-being and quality of life amongst those affected by cancer. This paper reflects on how we adapted our research management and study methods during the COVID-19 pandemic, and the implications for ongoing research practice. We use four case studies to consider the benefits and challenges of adapting to remote approaches to research and evaluation delivery: maintaining high ethical standards and data security in evaluation projects with remote approvals;recruiting for and running online discussion groups to inform intervention development;designing and delivering an in-person intervention via video conferencing;and adapting a longitudinal qualitative study to focus on newly emerging issues. We reflect on how we can maintain quality and rigour when conducting remote research and evaluation, and how this can affect our experience as researchers. We also consider possible implications of the uncertainty created by the COVID-19 pandemic for the funding and design of future research and evaluations. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Incidence of Respiratory Syncytial Virus Infection in Older Adults Before and During the COVID-19 Pandemic.

Importance: Little is known about the burden and outcomes of respiratory syncytial virus (RSV)-positive acute respiratory infection (ARI) in community-dwelling older adults. Objective: To assess the incidence of RSV-positive ARI before and during the COVID-19 pandemic, and to assess outcomes for RSV-positive ARI in older adults. Design, Setting, and Participants: This was a community-based cohort study of adults residing in southeast Minnesota that followed up with 2325 adults aged 50 years or older for 2 RSV seasons (2019-2021) to assess the incidence of RSV-positive ARI. The study assessed outcomes at 2 to 4 weeks, 6 to 7 months, and 12 to 13 months after RSV-positive ARI. Exposure: RSV-positive and -negative ARI. Main Outcomes and Measures: RSV status was the main study outcome. Incidence and attack rates of RSV-positive ARI were calculated during each RSV season, including before (October 2019 to April 2020) and during (October 2020 to April 2021) COVID-19 pandemic, and further calculated during non-RSV season (May to September 2021) for assessing impact of COVID-19. The self-reported quality of life (QOL) by Short-Form Health Survey-36 (SF-36) and physical functional measures (eg, 6-minute walk and spirometry) at each time point was assessed. Results: In this study of 2325 participants, the median (range) age of study participants was 67 (50-98) years, 1380 (59%) were female, and 2240 (96%) were non-Hispanic White individuals. The prepandemic incidence rate of RSV-positive ARI was 48.6 (95% CI, 36.9-62.9) per 1000 person-years with a 2.50% (95% CI, 1.90%-3.21%) attack rate. No RSV-positive ARI case was identified during the COVID-19 pandemic RSV season. Incidence of 10.2 (95% CI, 4.1-21.1) per 1000 person-years and attack rate of 0.42%; (95% CI, 0.17%-0.86%) were observed during the summer of 2021. Based on prepandemic RSV season results, participants with RSV-positive ARI (vs matched RSV-negative ARI) reported significantly lower QOL adjusted mean difference (limitations due to physical health, -16.7 [95% CI, -31.8 to -1.8]; fatigue, -8.4 [95% CI, -14.3 to -2.4]; and difficulty in social functioning, -11.9 [95% CI, -19.8 to -4.0] within 2 to 4 weeks after RSV-positive ARI [ie, short-term outcome]). Compared with participants with RSV-negative ARI, those with RSV-positive ARI also had lower QOL (fatigue: -4.0 [95% CI, -8.5 to -1.3]; difficulty in social functioning, -5.8 [95% CI, -10.3 to -1.3]; and limitation due to emotional problem, -7.0 [95% CI, -12.7 to -1.3] at 6 to 7 months after RSV-positive ARI [intermediate-term outcome]; fatigue, -4.4 [95% CI, -7.3 to -1.5]; difficulty in social functioning, -5.2 [95% CI, -8.7 to -1.7] and limitation due to emotional problem, -5.7 [95% CI, -10.7 to -0.6] at 12-13 months after RSV-positive ARI [ie, long-term outcomes]) independent of age, sex, race and/or ethnicity, socioeconomic status, and high-risk comorbidities. Conclusions and Relevance: In this cohort study, the burden of RSV-positive ARI in older adults during the pre-COVID-19 period was substantial. After a reduction of RSV-positive ARI incidence from October 2020 to April 2021, RSV-positive ARI re-emerged during the summer of 2021. RSV-positive ARI was associated with significant long-term lower QOL beyond the short-term lower QOL in older adults.

Diverse experiences and belonging in an online, first-year, team-based engineering design course

Cultivating a sense of belonging can be challenging in online contexts as well as for underrepresented students in engineering education. This study used a mixed methods sequential explanatory design to understand underrepresented students' experiences in a Canadian first-year course. Taking place during remote delivery due to COVID-19, we surveyed students about constructs related to belonging and team experience, finding significant differences between men and women as well as between the majority social group (white and South Asian men) and their peers in terms of whether they valued the diversity of the teaching assistant (TA) team, and whether the course contributed to their sense of belonging in engineering. Follow up interviews shed light on some of the differences in students' perceptions and experiences based on gender and ethnicity, and have implications for inclusive teaching strategies in first-year courses, in particular related to designing team activities and providing supports for peer-TA-instructor interactions.

The pandemic and future directions

This final chapter contains three key lessons for general and post-Covid conscious. First, listening to the voices of those with lived experience, hearing their understandings of what leisure and health is, their terms and terminologies and their understandings and experiences of discourses as empowering or disempowering. Secondly, the use of a diverse array of models and frameworks drawn from health, leisure, social sciences, even animal sciences and beyond, can enable us to perceive the total ecologies of our communities. The authors show that when we do this it is possible to see the intersections of leisure and health in unexplored ways, offering insights that can lead to creative and novel approaches of benefit to individuals, communities and societies. Thirdly, call to action. The authors make a call for all those interested in the leisure-health nexus to engage in actions that can progress leisure-health understandings, be this research to create stronger and specific evidence bases, or lobbying governments to action on climate change. Mobilizing within our democratic systems, when and where we can, is the call.

Re-Imagining Digital and New Media Literacies in Social Work Education: A Critical Framework for Overcoming #FakeNews, Divisiveness, and Injustice

Social unrest and division within the United States has become more visible and magnified since the 2016 election of former President Trump. This unrest has been amplified by the COVID-19 pandemic and white supremist attacks across the country. Throughout this era, information has been perpetuated through systemic and cultural networks promoting pseudoscience, #fakenews, misinformation, and explicit marginalization of racial, gender, ethnic, and cultural minorities. During this time, social work practitioners and educators have struggled to counter misinformation in classrooms and practice contexts. This paper proposes a newly re-imagined framework for addressing misinformation and civil discourse in social work education through the adoption and infusion of digital and new media literacies from within a critical theory driven epistemological framework. Recommendations are provided for incorporating tools, skills, and competencies throughout the curriculum in a more meaningful way that will help the profession combat misinformation, promote civil discourse, and utilize best practices in a digitally augmented society. Only then will the social work profession be able to meet the current and future challenges and opportunities that will undoubtedly accompany the expansion of digital technologies throughout our society. © 2022 Authors.

Social Work Students’ Self-Efficacy Toward Direct Practice Skills in Field Education Using Virtual Simulations and Scripted Role Plays

Simulations with professional actors and scripted role plays with peers are effective methods to increase direct practice skills. However, little is known about how simulations or scripted role plays conducted virtually can influence social work students' practice self-efficacy. MSW students enrolled in field seminar courses across two universities were invited to participate in an exploratory, repeated measures assessment utilizing the Counselor Activity Self-Efficacy Scales (CASES). One university (n=100) implemented the use of standardized clients, played by professional actors within field seminar;the other university (n=61) implemented scripted, peer-led role plays. Significant differences were found in pre/post scores among MSW students that participated in simulated client experiences within their field seminar. Simulations and scripted peer role plays may need to be more integrated into social work curricula when opportunities for in-person direct practice skill development are limited due to hybrid or fully remote field placements. Applied learning in social work education must be re-envisioned so programs can prepare MSW students to be effective practitioners in today’s rapidly changing environment. © 2022 Authors,.

What happens to hernias if we don't operate? A Covid-19 waiting list study

Aims: Many patients with symptomatic abdominal hernias have suffered delays and cancellations due to The reduction of elective operating lists. This waiting list study looks to examine what has happened to patients who were On The waiting list On The day of The first lockdown in March 2020, and whether there were any adverse outcomes. Method(s):We used coding data, TrakCare IT information and op notes to identify The outcomes of those patients between March 2020 and December 2021. We looked at whether elective surgery had been done, waiting times, if The patient had presented as an emergency, and if they had been removed from The list. We included any symptomatic abdominal hernia ie inguinal, incisional, paraumbilical, ventral. Result(s): There were 78 patients included. 33 had elective repair, min waiting time 6 months, max 18 months. There were 5 emergency presentations for operative repair (6.4%) including 1 death (3 inguinal, 2 incisional). A further 3 required expedited repair at 5, 8 and 9 months. 4 patients removed themselves due to improvement in symptoms and 27 patients remained On The list (min 19 months, max 27 months). Conclusion(s): Waiting lists for benign surgery have been adversely affected by The pandemic and this difficulty is seen clearly in our small district general. Patients who have been waiting a long time are at risk of emergency presentations and ongoing symptoms. Those with The fewest symptoms are waiting over two years and are at risk of continued waits due to ongoing service pressures.

Rates of Asymptomatic COVID-19 Infection and Associated Factors in Olmsted County, Minnesota, in the Prevaccination Era.

Objective: To estimate rates and identify factors associated with asymptomatic COVID-19 in the population of Olmsted County during the prevaccination era. Patients and Methods: We screened first responders (n=191) and Olmsted County employees (n=564) for antibodies to SARS-CoV-2 from November 1, 2020 to February 28, 2021 to estimate seroprevalence and asymptomatic infection. Second, we retrieved all polymerase chain reaction (PCR)-confirmed COVID-19 diagnoses in Olmsted County from March 2020 through January 2021, abstracted symptom information, estimated rates of asymptomatic infection and examined related factors. Results: Twenty (10.5%; 95% CI, 6.9%-15.6%) first responders and 38 (6.7%; 95% CI, 5.0%-9.1%) county employees had positive antibodies; an additional 5 (2.6%) and 10 (1.8%) had prior positive PCR tests per self-report or medical record, but no antibodies detected. Of persons with symptom information, 4 of 20 (20%; 95% CI, 3.0%-37.0%) first responders and 10 of 39 (26%; 95% CI, 12.6%-40.0%) county employees were asymptomatic. Of 6020 positive PCR tests in Olmsted County with symptom information between March 1, 2020, and January 31, 2021, 6% (n=385; 95% CI, 5.8%-7.1%) were asymptomatic. Factors associated with asymptomatic disease included age (0-18 years [odds ratio {OR}, 2.3; 95% CI, 1.7-3.1] and >65 years [OR, 1.40; 95% CI, 1.0-2.0] compared with ages 19-44 years), body mass index (overweight [OR, 0.58; 95% CI, 0.44-0.77] or obese [OR, 0.48; 95% CI, 0.57-0.62] compared with normal or underweight) and tests after November 20, 2020 ([OR, 1.35; 95% CI, 1.13-1.71] compared with prior dates). Conclusion: Asymptomatic rates in Olmsted County before COVID-19 vaccine rollout ranged from 6% to 25%, and younger age, normal weight, and later tests dates were associated with asymptomatic infection.

The multi-disciplinary team approach to screening for bone health in children with cystic fibrosis

Background: It is important to identify and treat lowbone mineral density (BMD) to prevent fractures and secondary complications. Individuals with cystic fibrosis (CF) are at risk of low BMD because of medication-related side effects, low body mass index, delayed puberty, and the effects of abnormal CF transmembrane conductance regulator. According to 2018 registry data, only 4% of patients aged 8 and older had completed a dualenergy X-ray absorptiometry (DEXA) scan at the Yale Pediatric CF Center. Our aim was to improve assessment of bone health by using a multidisciplinary team (MDT) to identify those at risk. Method(s): The MDT worked to identify patients at our center who were aged 8 and older and should undergo BMD screening based on the following risk factors: less than 90% of ideal body weight (our nurse coordinator queried from PortCF, and our dietician screened as part of regular nutritional assessment), percentage predicted forced expiratory volume in 1 second less than 50% (our nurse coordinator queried from PortCF, and our respiratory therapist screened as part of regular assessment), history of glucocorticoid use of 5 mg/d or more for more than 90 days per year or repeated antibiotic courses (our pharmacists queried medication history), history of fracture (our physical therapist added fracture screening to the regular musculoskeletal screen), history of delayed puberty or aged 18 and older (identified during weekly clinic conference). COVID delayed introduction of our plan. All members of the MDT were able to help explain the process and importance of DEXA scanning. The clinic nurse coordinator and PT monitored for scan completion and communicated with the team when results were available so that follow-up education and counseling could be provided. Dates of completed scan and recommended follow-up were added to the weekly clinic log for tracking. Result(s): Thirty-nine of 57 patients in our pediatric clinic met criteria for BMD assessment. The percentage of eligible patients completing screening rose from 4% in 2018 to 19.2% in 2019 and 33.3% in 2020 using a multidisciplinary approach to patient identification and education. As of March 2022, 51% of eligible patients had completed an initial assessment. Five of the 20 completed (20%) had results indicating low BMD for age. Three received referrals for additional physical therapy because of overall low physical activity levels and moderate postural deviations. The remaining two were already involved in regular physical activity. Education on safe bone-loading activity and protective education was provided. The team continues to provide dietary counseling and referrals to endocrine clinic as appropriate. One of the five patients with initial low BMD has undergone a 2-year follow-up scan and demonstrated significant improvement in BMD. Conclusion(s): A multidisciplinary approach to BMD screening was helpful. The percentage of eligible patients completing screening rose from 4% in 2018 to 19.2% in 2019 and 33.3% in 2020. We encountered challenges in getting all appropriate patients to complete their scans, largely because of COVID. Twenty-five percent of those scanned had low BMD for age. Standardizing multidisciplinary education and counseling will be an important next step, as will following the repeat scans of those whose initial scans were abnormal. Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Real-time surveillance of severe acute respiratory infections in Scottish hospitals: an electronic register-based approach, 2017-2022.

OBJECTIVES: The COVID-19 pandemic highlighted the importance of routine syndromic surveillance of respiratory infections, specifically new cases of severe acute respiratory infection (SARI). This surveillance often relies on questionnaires carried out by research nurses or transcriptions of doctor's notes, but existing, routinely collected electronic healthcare data sets are increasingly being used for such surveillance. We investigated how patient diagnosis codes, recorded within such data sets, could be used to capture SARI trends in Scotland. STUDY DESIGN: We conducted a retrospective observational study using electronic healthcare data sets between 2017 and 2022. METHODS: Sensitive, specific and timely case definition (CDs) based on patient diagnosis codes contained within national registers in Scotland were proposed to identify SARI cases. Representativeness and sensitivity analyses were performed to assess how well SARI cases captured by each definition matched trends in historic influenza and SARS-CoV-2 data. RESULTS: All CDs accurately captured the peaks seen in laboratory-confirmed positive influenza and SARS-CoV-2 data, although the completeness of patient diagnosis records was discovered to vary widely. The timely CD provided the earliest detection of changes in SARI activity, whilst the sensitive CD provided insight into the burden and severity of SARI infections. CONCLUSIONS: A universal SARI surveillance system has been developed and demonstrated to accurately capture seasonal SARI trends. It can be used as an indicator of emerging secondary care burden of emerging SARI outbreaks. The system further strengthens Scotland's existing strategies for respiratory surveillance, and the methods described here can be applied within any country with suitable electronic patient records.

Rates of Asymptomatic COVID-19 Infection and Associated Factors in Olmsted County, MN in the Pre-Vaccination Era

Objective To estimate rates and identify factors associated with asymptomatic COVID-19 in the population of Olmsted County during the pre-vaccination era. Patients and Methods We screened first responders (N=191) and Olmsted County employees (N=564) for antibodies to SARS-CoV-2 from November 2020 to February 2021 to estimate seroprevalence and asymptomatic infection. Second, we retrieved all PCR confirmed COVID-19 diagnoses in Olmsted County from March 2020 through January 2021, ed symptom information, estimated rates of asymptomatic infection and examined related factors. Results Twenty (10.5%;95%CI: 6.9%-15.6%) first responders and thirty-eight (6.7%;95% CI: 5.0%-9.1%) county employees had positive antibodies;an additional 5 (2.6%) and 10 (1.8%) had prior positive PCR tests per self-report or medical record, but no antibodies detected. Of persons with symptom information, 4/20, (20%, 95% CI: 3.0%-37.0%) of first responders and 10/39 (26%, 95% CI: 12.6%-40.0%) county employees, were asymptomatic. Of 6,020 positive PCR tests in Olmsted County with symptom information between March 1, 2020, and January 31, 2021, 6% (n=385;95% CI: 5.8%-7.1%) were asymptomatic. Factors associated with asymptomatic disease included age [0-18 years (OR=2.3, 95% CI: 1.7-3.1) and 65+ years (OR=1.40, 95% CI: 1.0-2.0) compared to ages 19-44 years], body-mass-index [overweight OR=0.58, 95% CI: 0.44-0.77) or obese (OR=0.48, 95% CI: 0.57-0.62) compared to normal or underweight] and tests after November 20, 2020 [(OR=1.35;95% CI: 1.13-1.71) compared to prior dates]. Conclusion Asymptomatic rates in Olmsted County prior to vaccine rollout ranged from 6-25%, and younger age, normal weight, and later tests dates were associated with asymptomatic infection.

Understanding the Health care Needs of Migrant Children in Government Custody

Background: There are increasing numbers of immigrant children held in government custody at the US-Mexico border and across the US. Further, anti-immigrant policies and the US COVID-19 pandemic response exacerbated detention conditions under the Trump administration. Thus, there is a greater need to identify the health concerns and challenges clinicians face when caring for these children. Methods: A national cross-sectional 66- question online survey was distributed from October 2020 to January 2021 through national pediatric and migrant health listservs including the Academy of Pediatrics (AAP). The reported total number of listserv members was 6200, but the degree of redundancy among these groups was not able to be assessed. Clinicians were asked about care delays, health problems encountered, and resources needed while caring for children under government custody. “Children in government custody” was defined as children (0-17 years) who currently or previously (in the past 5 years) were under the custody of the US Immigration Customs Enforcement, Customs Border Protection and/or the Office of Refugee and Resettlement. Results: Eightytwo clinicians responded and cared for children clinically. Thirty four cared for children who were in government custody. About 1/3 of this subset of respondents noted care delays while in custody and delays in establishing primary care after custody release. The two main health issues seen were a lack of routine health maintenance and traumatic exposures. Most commonly, children were behind on vaccinations and needed mental health screening. Exposure to violence was the most common traumatic exposure. Furthermore, 47% of clinicians felt that their current resources were inadequate and requested legal assistance and mental health support. Importantly, 58% of respondents were not aware of or were unsure of the Centers for Disease Control and Prevention domestic refugee health guidelines for the care of migrant children and adults. Conclusion: Children who experience detention have significant healthcare needs, many of which clinicians do not feel equipped to address. The reported health complications emphasize the need for policy measures, such as those recommended by the AAP, namely, the provision of evidence-based medical evaluations, trauma-informed care, and family-centered medical homes with comprehensive primary care and embedded mental health and legal support systems. Child detention should end. If present, children should be released to ORR shelters with pediatric clinicians providing healthcare and oversite until children can be safely released to vetted legal guardians and established in medical homes. This process should be swift with improved integration of detainment and post-detainment healthcare. Clinicians can be supported with training on immigrant screening guidelines. Of note, the low response rate and inability to distinguish between ICE, CBP, and ORR on the survey limits these results. Nonetheless, these findings support further research and recommendations for policy changes to improve the health and well-being of newly-arrived immigrant children.

Stoppage of exercise during the COVID-19 pandemic results in worsening liver enzymes in patients with metabolic associated fatty liver disease

Objectives: Worldwide, the COVID-19 pandemic has resulted in lifestyle disruptions, with lockdowns and curtailed activities. This was acutely felt in Asia from February 2020 onwards. Such drastic changes in lifestyle habits may impact negatively on metabolic related diseases. We explored these changes and their effects in patients with metabolic associated fatty liver disease (MAFLD). Materials and Methods: The data of MAFLD patients who were prospectively enrolled from eleven Asian centres in a longitudinal cohort study were analyzed. The data from 1st January 2019 (pre- COVID-19), were compared with the data from 1st February 2020 onwards (during COVID-19). Patients were stratified by physical activity level and whether they met target recommendation of[ 150 min of moderate/vigorous exercise per week. Results: A total of 229 patients were evaluated. Mean age was 59 ± 9.6 years with 136 (59.4%) males. During the COVID-19 pandemic, 50 (21.8%) patients maintained moderate/vigorous exercise, while 28 (12.2%) and 33 (14.4%) patients started and stopped moderate/vigorous exercising respectively. 118 patients (51.5%) did not participate in moderate/vigorous exercise either before or during the pandemic. Seventy-eight (34.1%) patients achieved[150 min moderate/vigorous exercise per week at the last visit. With the onset of COVID-19, reduction of physical activity of any kind was demonstrated in the majority (65.9%) of patients. There was a reduction of any physical activity including walking amongst those who stopped moderate/vigorous exercise and those without moderate/ vigorous exercise throughout. No significant changes in BMI, waist or hip circumference were observed in any activity level group. In patients who stopped moderate/vigorous exercise, alanine transaminase and aspartate transaminase significantly increased by 18.5% and 14.8% respectively. Conclusion: Stoppage of moderate/vigorous exercise leads to worsening of liver enzymes in patients with MAFLD and may have deleterious effects long term. As we adapt to live with COVID endemicity, novel modified healthy lifestyle habits would be needed to manage MAFLD.

Mental Health Facilitators and Barriers during Covid-19 in Nigeria

We investigated the most important mental health facilitators and barriers for a Nigerian sample during the COVID-19 pandemic. We collected data from 122 participants (72% females) using Online Photovoice (OPV) method. We used Online Interpretative Phenomenological Analysis (OIPA) approach and found nine facilitator themes. The four most reported facilitators were social support (34%);hobbies (26%);creating space for or experiencing enjoyable feelings, bodily sensations, and comfort (25%);and spirituality/religiosity (9%). Nine main barrier themes emerged (e.g. unenjoyable feelings, 53%;COVID-19 restrictions, 30%;inadequate social interaction, 19%;and financial issues, poverty, 18%). We discussed the implication and limitations of the findings.

In hospital outcomes in older adults with COVID-19 and epilepsy

COVID-19 causes high rates of mortality and morbidity in older adults, especially those with pre-existing conditions. Since epilepsy is associated with premature mortality, we aimed to evaluate in-hospital outcomes, including mortality, in older compared (>65) to younger adults (<65) with COVID-19 and epilepsy. We hypothesized that adults >65 years with epilepsy would have higher mortality despite adjustment for comorbidity. This retrospective study in a large multicenter New York health system included consecutive patients with epilepsy admitted with COVID-19 between 3/15/2020-5/17/2021. Epilepsy was identified using a validated ICD-CM based case definition. Outcomes were level of respiratory support, ICU admission, and mortality. Chi-square tests, Fisher's exact tests, Student's t-tests and Mann-Whitney U or Kolmogorov Smirnov tests were conducted as appropriate. Multivariable logistic regression models were generated to examine factors associated with mortality. We identified 173 older and 161 younger adults with epilepsy and COVID-19. Median age of older (>65) compared to younger (<65) adults was 74 vs. 52 (p<.001). A larger proportion of older adults died in hospital (35.8% vs. 23%, p=.01). Older adults were less likely to be discharged to home (21.4% vs. 38.5%, p<.001) and more likely to go to a chronic care facility (19.7% vs. 10.0%, p<.001). Ventilation status (35.8% vs. 39.8%, p=.45) or ICU admission rate (34.7% vs. 44.1%, p=.08) were not significantly different between the age groups. Older adults had higher odds of mortality after adjusting for sex, race, language and Charlson Comorbidity Index (CCI) (OR, 2.04;95% CI, 1.22-3.40, p=0.01). Within the over 65 group, increasing years of age (OR 1.07;95% CI 1.02-1.12, p=0.01), and increasing CCI score (OR 1.16, 95% CI 1.01-1.32, p=0.03) were associated with in-hospital mortality while sex, race, and language were not. Our study found higher in-hospital mortality in older compared to younger adults with epilepsy diagnosed with COVID-19. Consistent with prior work, increasing age and increasing number of comorbid diseases was associated with increased odds of mortality, reinforcing the need to communicate risks of multimorbidity and COVID-19 in older adults with epilepsy.