tetano
Editor, Senior Moderator
Age Ageing
. 2020 Nov 17;afaa258.
doi: 10.1093/ageing/afaa258. Online ahead of print.
Clinical profile and predictors of in-hospital mortality among older patients admitted for COVID-19
V?ctor Manuel Becerra-Mu?oz[SUP] 1 [/SUP], Iv?n J N??ez-Gil[SUP] 2 [/SUP], Charbel Maroun Eid[SUP] 3 [/SUP], Marcos Garc?a Aguado[SUP] 4 [/SUP], Rodolfo Romero[SUP] 5 [/SUP], Jia Huang[SUP] 6 [/SUP], Alba Mulet[SUP] 7 [/SUP], Fabrizio Ugo[SUP] 8 [/SUP], Francesco Rametta[SUP] 8 [/SUP], Christoph Liebetrau[SUP] 9 [/SUP], Alvaro Aparisi[SUP] 10 [/SUP], Inmaculada Fern?ndez-Rozas[SUP] 11 [/SUP], Mar?a C Viana-Llamas[SUP] 12 [/SUP], Gisela Feltes[SUP] 13 [/SUP], Martino Pepe[SUP] 14 [/SUP], Luis A Moreno-Rond?n[SUP] 15 [/SUP], Enrico Cerrato[SUP] 16 [/SUP], Sergio Raposeiras-Roub?n[SUP] 17 [/SUP], Emilio Alfonso[SUP] 18 [/SUP], Ana Carrero-Fern?ndez[SUP] 19 [/SUP], Luis Buz?n-Mart?n[SUP] 20 [/SUP], Mohammad Abumayyaleh[SUP] 21 22 [/SUP], Adelina Gonzalez[SUP] 23 [/SUP], Antonio Fern?ndez Ortiz[SUP] 2 [/SUP], Carlos Macaya[SUP] 2 [/SUP], Vicente Estrada[SUP] 2 [/SUP], Cristina Fern?ndez-P?rez[SUP] 2 [/SUP], Juan Jos? G?mez-Doblas[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and mortality, particularly in older patients.
Methods: Post-hoc analysis of the international, multicentre, "real-world" HOPE COVID-19 registry. All patients aged ≥65 years hospitalised for COVID-19 were selected. Epidemiological, clinical, analytical and outcome data were obtained. A comparative study between two age subgroups, 65-74 and ≥75 years, was performed. The primary endpoint was all cause in-hospital mortality.
Results: 1,520 patients aged ≥65 years (60.3% male, median age of 76 [IQR 71-83] years) were included. Comorbidities such as hypertension (69.2%), dyslipidemia (48.6%), cardiovascular diseases (any chronic heart disease in 38.4% and cerebrovascular disease in 12.5%), and chronic lung disease (25.3%) were prevalent, and 49.6% were on ACEI/ARBs. Patients aged 75 years and older suffered more in-hospital complications (respiratory failure, heart failure, renal failure, sepsis) and a significantly higher mortality (18.4 vs. 48.2%, P < 0.001), but fewer admissions to intensive care units (11.2 vs. 4.8%). In the overall cohort, multivariable analysis demonstrated age ≥75 (OR 3.54), chronic kidney disease (OR 3.36), dementia (OR 8,06), peripheral oxygen saturation at admission <92% (OR 5.85), severe lymphopenia (<500/mm3) (OR 3.36) and qSOFA (Quick Sequential Organ Failure Assessment Score) >1 (OR 8.31) to be independent predictors of mortality.
Conclusion: Patients aged ≥65 years hospitalised for COVID-19 had high rates of in-hospital complications and mortality, especially among patients 75 years or older. Age ≥75 years, dementia, peripheral oxygen saturation <92%, severe lymphopenia and qSOFA scale >1 were independent predictors of mortality in this population.
Keywords: Coronavirus disease 2019; SARS-CoV-2; comorbidities; older adults.
. 2020 Nov 17;afaa258.
doi: 10.1093/ageing/afaa258. Online ahead of print.
Clinical profile and predictors of in-hospital mortality among older patients admitted for COVID-19
V?ctor Manuel Becerra-Mu?oz[SUP] 1 [/SUP], Iv?n J N??ez-Gil[SUP] 2 [/SUP], Charbel Maroun Eid[SUP] 3 [/SUP], Marcos Garc?a Aguado[SUP] 4 [/SUP], Rodolfo Romero[SUP] 5 [/SUP], Jia Huang[SUP] 6 [/SUP], Alba Mulet[SUP] 7 [/SUP], Fabrizio Ugo[SUP] 8 [/SUP], Francesco Rametta[SUP] 8 [/SUP], Christoph Liebetrau[SUP] 9 [/SUP], Alvaro Aparisi[SUP] 10 [/SUP], Inmaculada Fern?ndez-Rozas[SUP] 11 [/SUP], Mar?a C Viana-Llamas[SUP] 12 [/SUP], Gisela Feltes[SUP] 13 [/SUP], Martino Pepe[SUP] 14 [/SUP], Luis A Moreno-Rond?n[SUP] 15 [/SUP], Enrico Cerrato[SUP] 16 [/SUP], Sergio Raposeiras-Roub?n[SUP] 17 [/SUP], Emilio Alfonso[SUP] 18 [/SUP], Ana Carrero-Fern?ndez[SUP] 19 [/SUP], Luis Buz?n-Mart?n[SUP] 20 [/SUP], Mohammad Abumayyaleh[SUP] 21 22 [/SUP], Adelina Gonzalez[SUP] 23 [/SUP], Antonio Fern?ndez Ortiz[SUP] 2 [/SUP], Carlos Macaya[SUP] 2 [/SUP], Vicente Estrada[SUP] 2 [/SUP], Cristina Fern?ndez-P?rez[SUP] 2 [/SUP], Juan Jos? G?mez-Doblas[SUP] 1 [/SUP]
Affiliations
- PMID: 33201181
- DOI: 10.1093/ageing/afaa258
Abstract
Background: The coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and mortality, particularly in older patients.
Methods: Post-hoc analysis of the international, multicentre, "real-world" HOPE COVID-19 registry. All patients aged ≥65 years hospitalised for COVID-19 were selected. Epidemiological, clinical, analytical and outcome data were obtained. A comparative study between two age subgroups, 65-74 and ≥75 years, was performed. The primary endpoint was all cause in-hospital mortality.
Results: 1,520 patients aged ≥65 years (60.3% male, median age of 76 [IQR 71-83] years) were included. Comorbidities such as hypertension (69.2%), dyslipidemia (48.6%), cardiovascular diseases (any chronic heart disease in 38.4% and cerebrovascular disease in 12.5%), and chronic lung disease (25.3%) were prevalent, and 49.6% were on ACEI/ARBs. Patients aged 75 years and older suffered more in-hospital complications (respiratory failure, heart failure, renal failure, sepsis) and a significantly higher mortality (18.4 vs. 48.2%, P < 0.001), but fewer admissions to intensive care units (11.2 vs. 4.8%). In the overall cohort, multivariable analysis demonstrated age ≥75 (OR 3.54), chronic kidney disease (OR 3.36), dementia (OR 8,06), peripheral oxygen saturation at admission <92% (OR 5.85), severe lymphopenia (<500/mm3) (OR 3.36) and qSOFA (Quick Sequential Organ Failure Assessment Score) >1 (OR 8.31) to be independent predictors of mortality.
Conclusion: Patients aged ≥65 years hospitalised for COVID-19 had high rates of in-hospital complications and mortality, especially among patients 75 years or older. Age ≥75 years, dementia, peripheral oxygen saturation <92%, severe lymphopenia and qSOFA scale >1 were independent predictors of mortality in this population.
Keywords: Coronavirus disease 2019; SARS-CoV-2; comorbidities; older adults.