Clinical course and prognostic factors of COVID-19 infection in an elderly hospitalized population

Mostaza, José María; García-Iglesias, Francisca; González-Alegre, Teresa; Blanco, Francisco J.; Varas, Marta; Hernández-Blanco, Clara; Hontañón, Víctor; Jaras-Hernández, María J.; Martínez-Prieto, Mónica; Menéndez-Saldaña, Araceli; Cachán, María L.; Estirado, Eva; Lahoz, Carlos; Miguel, Rosa de; Romero, Míriam; Lago, Mar; García-Quero, Cristina; Plaza, Cristina; Sainz-Costa, Talía; Rivas-Vila, Susana; Sánchez, Blanca; Torres, Celia García; Martínez-Tobar, Lucía; Hernández‐Pérez, María; Racionero, Pablo; Mir-Ihara, Patricia; Peña-López, Jesús; Bautista-Barea, Marta; Benitez, A; Rodríguez-Merlos, Pablo; Barcenilla, María; Basilio, María San; Valencia, Eulalia; Romero-Martín, Ricardo; Boto-de-los-Bueis, Ana; Hoz-Polo, Adriana de la; Pino-Cidad, María del; Coca-Robinot, Javier; González-Ferrer, Bárbara; Fernández-Pérez, Pedro; Mogollón, Isabel Cristina Meléndez; Montoro-Romero, María S.; Villalaín, Isabel; Hierro-Zarzuelo, Almudena del; Hernández‐Martín, Irene; Domı́nguez, Javier; Luna, A.; Montoro, Soledad; Sánchez-Orgaz, Margarita; Amorena, Gloria; Lavín-Dapena, Cosme; Negreiros, Aaron Zapata

doi:10.1016/j.archger.2020.104204

Cited by 53 publications

(59 citation statements)

References 18 publications

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“…In this study, we assessed the clinical characteristics at the admission of patients with more severe infections admitted to our hospital in the first wave of the COVID-19 pandemic. The overall proportion of deaths was 32%, much higher than that observed in China [ 4 , 5 ], similar to that reported in other areas of Spain [ 6 , 7 , 8 ] and neighboring European countries [ 9 , 10 ], and lower than that reported in United States [ 11 ], for the same age ranges. The threshold of severity required for hospitalization could explain some of these differences, as too could the incomplete follow up of patients assessed in some studies.…”

Section: Discussionsupporting

confidence: 75%

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Maestre-Muñiz

Arias

Arias-González

et al. 2021

JCM

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Background: Risk factors for in-hospital mortality from severe coronavirus disease 2019 (COVID-19) infection have been identified in studies mainly carried out in urban-based teaching hospitals. However, there is little data for rural populations attending community hospitals during the first wave of the pandemic. Methods: A retrospective, single-center cohort study was undertaken among inpatients at a rural community hospital in Spain. Electronic medical records of the 444 patients (56.5% males) admitted due to severe SARS-CoV-2 infection during 26 February 2020–31 May 2020 were reviewed. Results: Mean age was 71.2 ± 14.6 years (rank 22–98), with 69.8% over 65. At least one comorbidity was present in 410 patients (92.3%), with chronic obstructive pulmonary disease (COPD) present in 21.7%. Overall in-hospital mortality was 32%. Multivariate analysis of factors associated with death identified patients’ age (with a cumulative effect per decade), COPD as a comorbidity, and respiratory insufficiency at the point of admission. No additional comorbid conditions proved significant. Among analytical values, increased serum creatinine, LDH > 500 mg/dL, thrombocytopenia (<150 × 109/per L), and lymphopenia (<1000 cells/µL) were all independently associated with mortality during admission. Conclusions: Age remained the major determinant for COVID-19-caused mortality; COPD was the only comorbidity independently associated with in-hospital death, together with respiratory insufficiency and analytical markers at admission.

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Section: Discussionsupporting

confidence: 75%

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Maestre-Muñiz

Arias

Arias-González

et al. 2021

JCM

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“…We highlight the high proportion of institutionalized patients in our sample (61%), re ecting a population with greater clinical fragility and therefore with less ability to respond to an organic stressor. Thus, the series reported by Gutiérrez-Rodríguez et al (11) had a mortality (41%) and a proportion of institutionalized patients (70%) more similar to those of our sample than those reported by Mostaza et al (mortality 35% and proportion of institutionalized 23%) (20). In neighbouring countries, Zerah et al (France) (29) reported a lower lethality (31%) in a cohort of 821 hospitalized patients aged 70 or older, although with a proportion of institutionalized patients much lower than our sample (29%).…”

Section: In-hospital Mortalitysupporting

confidence: 85%

“…Previous treatments have not been evaluated as prognostic factors in the before mentioned trials(9-11) so we cannot compare our results with them. In a younger cohort, Mostaza et al (20), in people older than 75 years, did nd a better prognosis in patients who previously took reninangiotensin-aldosterone system antagonists. Regarding previous chronic diseases, our results are similar to the study by Ramos-Rincon et al (9); however, Covino et al (10) reported severe dementia as an independent risk factor for death, although age, since it was not apparently included in their multivariate analysis, cannot be rule out as a confounding factor.…”

Section: Predictors Of Severe Disease and Mortalitymentioning

confidence: 91%

Covid-19 in the Oldest-old Population (80 and Older): Clinical Presentation and Prognostic Factors of Severe Disease and Mortality. A Cohort Study.

Gálvez‐Barrón

Arroyo-Huidobro

Miñarro

et al. 2020

Preprint

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BACKGROUND The oldest-old population (80 years or older) has the highest lethality from COVID-19. There is little information on the clinical presentation and specific prognostic factors for this group. This trial evaluated the clinical presentation and prognostic factors of severe disease and mortality in the oldest-old population.METHODS Ambispective cohort study of oldest-old patients hospitalized for respiratory infection associated with COVID-19 and with a positive test by real-time polymerase chain reaction. The clinical presentation and the factors associated with severe disease and mortality were evaluated (logistic regression). All patients were followed until discharge or death.RESULTS A total of 103 patients (59.2% female) were included. The most frequent symptoms were fever (68.9%), dyspnoea (60.2%), and cough (39.8%), and 11.7% presented confusion. Fifty-nine patients (57.3%) presented severe disease, and 59 died, with 43 patients (41.7%) presenting both of these. In the multivariate analysis, male sex (OR 0.31, 95% confidence interval [95% CI] 0.13-0.73, p 0.0074) and serum lactate dehydrogenase (LDH) (OR 2.55, 95% CI 1.21-5.37, p 0.0139) were associated with severe disease, and serum sodium was associated with mortality (OR 3.12, 95% CI 1.18-8.26, p 0.0222). No chronic disease or pharmacological treatment were associated with worse outcomes.CONCLUSIONS The typical presenting symptoms of respiratory infection in COVID-19 are less frequent in the oldest-old population. Male sex and LDH level are predictors of severe disease, and serum sodium level predicts of mortality in this population.

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“…Prognostication of COVID-19 mortality is currently being heavily investigated such that patient risk and outcomes may be further stratified. Some prognostic factors associated with mortality in patients infected with SARS-CoV-2 include elevated CRP, LDH, and aminotransferases, acute onset of symptoms, fever and dyspnea, tachypnea, low oxygen saturation on admission, and lower platelet count [29 , 30] . Although these data were published several months following the death of our patient, it appears that our patient had several significant prognostic factors associated with increased mortality, such as elevated CRP, LDH, tachypnea, cerebrovascular disease, low oxygen saturation on admission, and acutely progressive disease.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 infection leading to ischemic and hemorrhagic brain lesions and acute respiratory distress syndrome

Thibodeau¹,

Jafroodifar²,

Quraeshi³

et al. 2021

Radiology Case Reports

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Clinical course and prognostic factors of COVID-19 infection in an elderly hospitalized population

Cited by 53 publications

References 18 publications

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Covid-19 in the Oldest-old Population (80 and Older): Clinical Presentation and Prognostic Factors of Severe Disease and Mortality. A Cohort Study.

SARS-CoV-2 infection leading to ischemic and hemorrhagic brain lesions and acute respiratory distress syndrome

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