Clinical, biological and radiological features, 4-week outcomes and prognostic factors in COVID-19 elderly inpatients

Abstract

Objective. To describe clinical, biological, radiological presentation and W4 status in COVID-19 elderly patients.Patients and methods. All patients ≥70 years with confirmed SARS-CoV-2 infection and hospitalized in the Infectious Diseases department of the Pitié-Salpêtrière hospital, Paris, France, from March 1 st to April 15 th 2020 were included. The primary outcome was death 4 weeks after hospital admission. Data on demographics, clinical features, laboratory tests, CTscan findings, therapeutic management and complications was collected.Results. Overall, 100 patients were analyzed, including 49 patients ≥80 years. Seventy percent had ≥2 comorbidities. Respiratory features were often severe as 48% needed oxygen support upon admission. Twenty-eight out of 43 patients (65%) with a CT-scan had a mild to severe parenchymal impairment, and 38/43 (88%) a bilateral impairment. Thirty-two patients presented a respiratory distress requiring oxygen support ≥6 liters/minute. Twenty-four deaths occurred, including 21 during hospitalization in our unit, 2 among the 8 patients transferred in ICU, and one at home after discharge from hospital, leading to a global mortality rate of 24% at W4. Age, acute renal failure and respiratory distress were associated with mortality at W4. Conclusion.Elderly COVID-19 patients with several comorbidities and severe clinical features survived in a substantial proportion, which could argue against transferring the most fragile patients in ICU.

Panorama das internações por covid-19 entre pessoas idosas residentes em Minas Gerais, Brasil

“…Tais achados são sustentados por estudo realizado no Brasil que também encontrou predomínio das mesmas características 12 . De forma semelhante, outras pesquisas encontraram dispneia, febre e tosse 11,[13][14][15]17 .…”

“…Do total de casos analisados, houve predomínio de indivíduos que evoluíram para cura, o que condiz com estudos anteriores 13,14 . Apesar das frequentes formas respiratórias graves e fatores de risco, pessoas idosas hospitalizadas por covid-19 sobrevivem à infecção 17 . Destaca-se que desde o início da pandemia da covid-19, a idade avançada tem sido apontada como fator de risco para desfechos negativos 9,34 , porém, verifica-se que uma parcela de casos pode ter evoluído para cura, possivelmente, devido ao desenvolvimento de terapêuticas e vacinas, que mostraram resultados positivos sobre a gravidade dos casos e taxas de mortalidade 4 .…”

“…A presença de alterações em exames laboratoriais 11,14,17 e de imagem [11][12][13][14][15] , além de desfechos adversos, como a demanda por suporte ventilatório [10][11][12][13] e óbito 11,14 , também são características identificadas em uma parcela das pessoas idosas internadas com a doença.…”

Evaluation of Biomarkers and Severity of COVID-19 in A Single Center

“…Infected patients show varying clinical outcomes as asymptomatic, mild, or critical, according to international guidelines [3]. The severity of the disease and mortality appear to be related to some risk factors, including age and numerous comorbidities like diabetes mellitus and hypertension, considering the epidemiological data [4]. On the other hand, among symptomatic patients, nearly 15% J Microbiol Infect Dis www.jmidonline.org Vol 12, No 3, September 2022 needed to be hospitalized, and 5% of them were classified as requiring intensive care [3].…”

Prevalence of COVID‐19 anxiety, geriatric anxiety, and related factors among the elderly in Quchan, Iran during the COVID‐19 pandemic: a cross‐sectional study

“…2 From the onset of the COVID-19 pandemic in Iran until September 6, 2023, a total of 7 613 757 COVID-19 cases have been identified, with approximately 146 329 fatalities. 3 Elderly individuals are particularly vulnerable to contracting COVID-19, 4,5 and the majority of deaths have occurred within this age group. 6 COVID-19 anxiety and geriatric anxiety have emerged as negative consequences following the pandemic.…”