Clinical features and short-term outcomes of elderly patients with COVID-19

Abstract

Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has become a global public health emergency. Methods: 204 elderly patients (!60 years old) diagnosed with COVID-19 in Renmin Hospital of Wuhan University from January 31st to February 20th, 2020 were included in this study. Clinical endpoint was inhospital death. Results: Of the 204 patients, hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease (COPD) were the most common coexisting conditions. 76 patients died in the hospital. Multivariate analysis showed that dyspnea (hazards ratio (HR) 2.2, 95% confidence interval (CI) 1.414-3.517; p < 0.001), older age (HR 1.1, 95% CI 1.070-1.123; p < 0.001), neutrophilia (HR 4.4, 95% CI 1.310-15.061; p = 0.017) and elevated ultrasensitive cardiac troponin I (HR 3.9, 95% CI 1.471-10.433; p = 0.006) were independently associated with death. Conclusion:Although so far the overall mortality of COVID-19 is relatively low, the mortality of elderly patients is much higher. Early diagnosis and supportive care are of great importance for the elderly patients of COVID-19.

Older adults hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey

“…These gures also re ect the rapid course and more prevalent adverse outcomes of the Covid-19 in older adults, which is in line with the previous recent studies (8) (12). The fatality rate among older adults has been reported higher as 37.3% in which the authors noted that most of the patients had to be isolated at home without medical support due to lack of in-patient hospital beds (7). This point is, therefore, important suggesting that again, earlier supportive measures may improve prognosis in older adults.…”

“…It seems that the more extensive pulmonary involvement on presentation re ected by the presence of dyspnea, tachypnea, and low oxygen saturation, is probably the main driver of the fatality in the course of this disease. Our ndings, together with the others, support the suggestion that older adults should be evaluated carefully for early diagnosis of the disease, which may hopefully reduce mortality rates by the introduction of supportive respiratory measures earlier (7,12). On the other hand, other studies noted some additional factors, with some differences between each other associated with higher mortality, e.g., older age, male gender, neutrophilia, lymphopenia, elevated troponin or D-dimer levels, underlying chronic diseases, cardiovascular diseases, chronic obstructive pulmonary disease, elevated creatinine and procalcitonin levels (6,7,12).…”

“…This is valuable as it supports the general medical principle that the clinical evaluation of the patient is more important than the laboratory examinations in medical assessment. This result has also been reported indirectly, as the presence of dyspnea was an independent correlate of mortality in the studies that could have performed multivariate analysis for correlates of mortality in the older adults (6,7,12). It seems that the more extensive pulmonary involvement on presentation re ected by the presence of dyspnea, tachypnea, and low oxygen saturation, is probably the main driver of the fatality in the course of this disease.…”

“…The overall death rate was 2.6%, but 70% of the overall deaths were in people aged 65 years or older (14). Despite the vulnerability of the older population, speci c information about the clinical characteristics of the disease in older adults is limited in the literature (6)(7)(8)(9)(10)(11)(12). To our knowledge, only seven studies were focusing on older adults, all reported from China.…”

“…Older adults have been continuously reported to be at higher risk for adverse outcomes of Covid-19 (4)(5)(6). However, the speci c information about older patients is limited despite their signi cant involvement with the disease (6)(7)(8)(9)(10)(11)(12).…”