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Ir J Med Sci . A retrospective cohort study of risk factors and outcomes in older patients admitted to an inner-city geriatric unit in London during

tetano

Editor, Senior Moderator
Ir J Med Sci


. 2021 Jul 6.
doi: 10.1007/s11845-021-02679-z. Online ahead of print.
A retrospective cohort study of risk factors and outcomes in older patients admitted to an inner-city geriatric unit in London during first peak of COVID-19 pandemic


Carmela Maniero[SUP] 1 [/SUP], Devan Patel[SUP] 2 [/SUP], Asha Pavithran[SUP] 2 [/SUP], Prasheena Naran[SUP] 2 [/SUP], Fu Liang Ng[SUP] 1 3 [/SUP], John Prowle[SUP] 4 [/SUP], Dhanupriya Sivapathasuntharam[SUP] 5 [/SUP]



Affiliations

Abstract

Purpose: Compared to younger patients, coronavirus disease 2019 (COVID-19) clinical presentation in older people can be more heterogeneous and fatal. We aim to describe a cohort of older adults admitted in an inner-city London hospital during the first peak of the pandemic.
Methods: A retrospective observational study that enrolled older adults consecutively admitted into two geriatric wards with suspected or confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We collected socio-demographic data, comorbidities, symptoms at presentation and/or during admission, biochemical and radiological data and outcomes at 28 days.
Results: One hundred twenty-four patients were included, and 75% were > 80 years old. 19.5% of COVID-19 cases were judged to be hospital-acquired. More than half presented or developed typical symptoms, respiratory failure or fatigue. 46.8% were diagnosed with delirium, 24.2% with falls and dysphagia was present in 13.7%. The mortality rate was 29.8% and was higher among males, those > 80 years, patients with a higher grade of frailty, a history of dementia or chronic kidney disease, as well as those diagnosed with respiratory failure, acute kidney injury or hypernatremia. Independent predictors of mortality were male sex, age > 80 years, respiratory failure and hypernatremia.
Conclusion: We have described a cohort of patients with SARS-CoV-2 infection in the first UK peak of the global pandemic. We found that these patients had significant frailty with multiple comorbidities. There was a high mortality and increased dependency and greater social care need in survivors.

Keywords: COVID-19; Coronavirus pandemic; Frailty; SARS-CoV-2.
 
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