Clinical Characteristics of Hospitalized Individuals Dying With COVID-19 by Age Group in Italy

Abstract

Background Aim of the present study is to describe characteristics of COVID-19-related deaths and to compare the clinical phenotype and course of COVID-19-related deaths occurring in adults (<65 years) and older adults (≥65 years). Method Medical charts of 3,032 patients dying with COVID-19 in Italy (368 aged < 65 years and 2,664 aged ≥65 years) were revised to extract information on demographics, preexisting comorbidities, and in-hospital complications leading to death. Results Older adults (≥65 years) presented with a higher number of comorbidities compared to those aged <65 years (3.3 ± 1.9 vs 2.5 ± 1.8, p < .001). Prevalence of ischemic heart disease, atrial fibrillation, heart failure, stroke, hypertension, dementia, COPD, and chronic renal failure was higher in older patients (≥65 years), while obesity, chronic liver disease, and HIV infection were more common in younger adults (<65 years); 10.9% of younger patients (<65 years) had no comorbidities, compared to 3.2% of older patients (≥65 years). The younger adults had a higher rate of non-respiratory complications than older patients, including acute renal failure (30.0% vs 20.6%), acute cardiac injury (13.5% vs 10.3%), and superinfections (30.9% vs 9.8%). Conclusions Individuals dying with COVID-19 present with high levels of comorbidities, irrespective of age group, but a small proportion of deaths occur in healthy adults with no preexisting conditions. Non-respiratory complications are common, suggesting that the treatment of respiratory conditions needs to be combined with strategies to prevent and mitigate the effects of non-respiratory complications.

Risk Factors for Hospitalization, Mechanical Ventilation, or Death Among 10 131 US Veterans With SARS-CoV-2 Infection

“… 21 , 28 , 29 , 30 , 31 , 32 The percentages of patients who require mechanical ventilation has ranged from 2.3% of the Chinese population to 93.2% of critically ill patients infected with SARS-CoV-2 admitted to New York area hospitals. 1 , 4 , 7 , 9 , 10 , 14 , 24 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 Short-term mortality rates in the US population are estimated to be between 1.8% and 3.4%, 2 which is higher than the 1.4% estimate from China earlier in the pandemic. 33 However, short-term mortality rates in case series of hospitalized patients and high-risk populations have been much higher, ranging from 10.2% to 67%.…”

Sex differences in clinical phenotype and transitions of care among individuals dying of COVID-19 in Italy

“…Compared with men, women were less likely to exhibit fever, SOB, and cough as symptoms at admission. Median time from onset of symptoms to hospital admission, testing with nasopharyngeal swab, ICU admission, and death were 4 [IQR, 2-7], 5 [IQR, 3-9], 8 [IQR, [5][6][7][8][9][10][11][12], and 11 [IQR, 7-17] days, respectively. Men were more likely to experience delays in the admission to hospital and the in-hospital nasopharyngeal swab testing as compared with women.…”

“…The reasons behind the male to female case fatality ratio remains mostly unknown. Overall, among the leading factors reported to strongly influence the risk of dying from COVID-19, older age (older than 65 years) and the presence of comorbidities, such as cardiovascular disease and chronic obstructive pulmonary disease (COPD) have emerged [11,12]. Nevertheless, sex-specific data regarding the distribution of comorbidities, the clinical manifestations at presentation, and the transitions of care among individuals with severe disease are needed for better understanding of the disease and tailoring of prevention strategies.…”

Revisión sobre obesidad como factor de riesgo para mortalidad por COVID-19

“…Luego de la lectura por títulos y resúmenes se excluyeron 124 estudios por no abordar los criterios de nuestra pregunta PICO (del inglés: patient, intervention, comparison, outcome); quedando 29 artículos para lectura a texto completo. Tras la lectura se excluyeron ocho artículos [8][9][10][11][12][13][14][15] por reportar únicamente obesidad como característica de la población general del estudio y 11 [15][16][17][18][19][20][21][22][23][24][25] artículos que por no reportar frecuencias o medidas de asociación entre obesidad y mortalidad (Figura 1). Al final, quedaron 10 artículos para esta revisión.…”