Clinical Characteristics and Predictors of Mortality in Elderly Patients Hospitalized with COVID-19 in Bangladesh: A Multicenter, Retrospective Study

Asaduzzaman, Md; Alam, Zahidul; Bari, Mohammad Zabed Jillul; Alam, Munsi Mohammad Jahangir; Chakraborty, Shishir Ranjan; Ferdousi, Tasnim

doi:10.1155/2022/5904332

Cited by 4 publications

(1 citation statement)

References 63 publications

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“…In the present study, age, IGs, LDH, ferritin, chest X-ray score and the absence of full vaccination, cough and fatigue were significantly and independently associated with the in-hospital mortality of this older population. -------------------------- The majority of these findings are consistent with those of previous studies of the in-hospital mortality of elderly patients with COVID-19 (14,16,(24)(25)(26)(27). Among studies in the general population, age has been reported as an independent predictor of mortality within 1 year after COVID-19 (28,29).…”

Section: Discussionsupporting

confidence: 89%

Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia

Georgakopoulou,

Gkoufa,

Makrodimitri

et al. 2023

Exp Ther Med

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Coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and a high mortality rate, particularly among elderly patients. Since the beginning of the pandemic, an older age has been recognized as a critical risk factor for disease severity, with increasing mortality rates in each decade of life. This phenomenon may be a consequence of a poor previous health status, with a higher prevalence of pre-existing comorbidities and a higher degree of frailty. The majority of studies on the outcomes and risk factors of elderly patients refer to the first waves of the pandemic and the predictors of in-hospital mortality in these patients. The aim of the present study was to provide a detailed description of the clinical characteristics and management of a cohort of elderly patients (≥65 years of age) who were hospitalized with COVID-19-related pneumonia in all phases of the pandemic, presenting their outcomes, and investigating predictors of in-hospital and out-of-hospital mortality over a period of 1 year in this particularly vulnerable population. A total of 1,124 elderly patients (603 males, 53.7%) with a mean age of 78.51±7.42 years and a median Charlson comorbidity index (CCI) of 5 were included in the study. Of these patients, 104 (9.3%) were hospitalized during the period of prevalence of the original strain Wuhan, 385 (34.3%) were hospitalized during the period of prevalence of the Alpha variant, 221 (19.7%) were hospitalized during the period of prevalence of the Delta variant, and 414 (36.8%) were hospitalized during the period of prevalence of the Omicron variant. Overall, the in-hospital mortality rate was 33.4% (375 patients), and the 1-year mortality rate was 44.7% (502 patients). The majority of patients had not been vaccinated or had not completed full vaccination against severe acute respiratory syndrome coronavirus-2 (843 patients, 75%), given the period of infection. Age, immature granulocytes, lactate dehydrogenase (LDH) levels, ferritin levels, chest X-ray score, as well as the absence of full vaccination, cough and fatigue, were statistically significantly and independently associated with in-hospital mortality, while age, LDH levels, ferritin levels, alanine aminotransferase levels, CCI, chest X-ray score, the absence of cough and fatigue, and a history of dementia were statistically significantly and independently associated with 1-year mortality. On the whole, the present study demonstrates that both the in-hospital mortality and 1-year mortality rates of elderly patients hospitalized due to COVID-19-related pneumonia are high.

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Section: Discussionsupporting

confidence: 89%

Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia

Georgakopoulou,

Gkoufa,

Makrodimitri

et al. 2023

Exp Ther Med

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The global case fatality rate due to COVID-19 in hospitalized elderly patients by sex, year, gross domestic product, and continent: A systematic review, meta-analysis, and meta-regression

Esmaeili¹,

Azizi²,

Sarbazi³

et al. 2023

New Microbes and New Infections

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Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study

Islam,

Salahin,

Chowdhury

et al. 2024

BMJ Open

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ObjectiveTo identify the associations of in-hospital cardiovascular events and mortality with pre-existing comorbidities and cardiovascular disease (CVD) risk factors among COVID-19 patients in Bangladesh without vaccine availability.DesignA secondary analysis of a prospective multicountry study.SettingThree COVID-19-designated hospitals in Bangladesh.ParticipantsAdult patients aged ≥18 years with PCR-positive COVID-19 admitted between 10 October 2020 and 31 July 2021 at participating hospitals.Outcome measuresIn-hospital cardiovascular events and mortality.Main exposuresPre-existing comorbidities and cardiovascular risk factors.ResultsIn 897 COVID-19 patients, 18.7% developed cardiovascular events and 12.6% died. After adjusting for clinical information and treatment, patients with two comorbidities (excluding CVD risk factors) were significantly associated with cardiovascular events (adjusted (adj.) OR 2.47, 95% CI 1.24 to 4.90). Patients with a higher heart rate at admission (adj. OR 1.03, 95% CI 1.01 to 1.04) and those who were receiving intravenous fluids (adj. OR 2.13, 95% CI 1.23 to 3.70) or antibiotics (adj. OR 4.54, 95% CI 1.47 to 14.01) had significantly higher odds of cardiovascular events. The odds of cardiovascular events were lower in those receiving antiviral medications (adj. OR 0.31, 95% CI 0.18 to 0.53). There were no interactions between comorbidities and other covariates in the models. Comorbidities and cardiovascular risk factors were not significantly associated with 30-day mortality in the Cox regression models after adjusting with clinical information and treatment. The mortality within 30 days of admission was significantly higher in patients receiving corticosteroids (adj. HR 2.82, 95% CI 1.48 to 5.38) and lower in those receiving antiviral treatment (adj. HR 0.53, 95% CI 0.34 to 0.81). Those having cardiovascular events significantly increased mortality hazard.ConclusionsClinical factors and treatment affected in-hospital cardiovascular events, which subsequently increased the risk of mortality within 30 days for COVID-19 patients. COVID-19 patients regardless of CVD risk factors and comorbidities require close monitoring for cardiovascular events.

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Clinical Characteristics and Predictors of Mortality in Elderly Patients Hospitalized with COVID-19 in Bangladesh: A Multicenter, Retrospective Study

Cited by 4 publications

References 63 publications

Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia

Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia

The global case fatality rate due to COVID-19 in hospitalized elderly patients by sex, year, gross domestic product, and continent: A systematic review, meta-analysis, and meta-regression

Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study

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