Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

Abstract

Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

Comparison of Clinical Characteristics and Outcomes of Younger and Elderly Patients with Severe COVID-19 in Korea: A Retrospective Multicenter Study

“…This study showed that hypertension was the most common comorbidity in this study, and elderly patients frequently presented with DM, COPD, cardiovascular disease, and heart failure. These results are similar to those of other studies showing that patients commonly had hypertension, and diabetes, cardiovascular disease, hypercholesterolemia, chronic lung disease, and malignancy were the frequent comorbidities [20][21][22][23][24]. In this research, elderly patients had lower NLRs, hemoglobin and albumin levels, and higher BUN levels.…”

“…Tan et al showed that 47.2% of patients who died from COVID-19 were elderly (≥70 years) [19]. Singhal et al revealed that 51% of older patients with COVID-19 (≥60 years) had severe infection and 22% of patients were critically ill [20]. In the study by Agnieszka et al, 50% of elderly patients with COVID-19 (≥60 years) were hospitalized (50.5%), of whom 23.5% were admitted at the ICU [21].…”

Effect and Tolerability of a Nutritional Supplement Based on a Synergistic Combination of β-Glucans and Selenium- and Zinc-Enriched Saccharomyces cerevisiae (ABB C1®) in Volunteers Receiving the Influenza or the COVID-19 Vaccine: A Randomized, Double-Blind, Placebo-Controlled Study

“…There is consistent evidence that healthcare workers on the frontline, older adults, and particularly elderly people with comorbidities have been at higher risk and poorer outcome when infected by the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) [1,2]. Reduced effectiveness of the immune system associated with advanced age (immunosenescence) has shown to be a contributory factor in the development of severe COVID-19 [3].…”

Pan-Cancer Analysis of Genomic and Prognostic Characteristics Associated With Coronavirus Disease 2019 Regulators

“…The clinical symptoms of COVID-19 range from asymptomatic to severe cardiopulmonary disease (16)(17)(18). Enhanced expression of ACE2 and immunosuppressive states caused by malignancies and anticancer treatments, such as chemotherapy or surgery, contribute to more severe disease in older patients with COVID-19 (19,20).…”