Clinical outcomes of geriatric patients with COVID-19: review of one-year data

Abstract

Aims In this study, we aimed to reveal mortality rates and factors affecting survival in geriatric patients infected with COVID-19. Methods This is a retrospective study of 873 geriatric patients with COVID-19 who were hospitalized between March 11, 2020 and March 11, 2021. Demographic, clinical, laboratory data, and treatment options were obtained from electronic medical records. Multivariate logistic regression was used to explore the risk factors for in-hospital death. Results During the specified period, 643 patients were discharged, and 230 patients died in the hospital. The mean age was 75.08 ± 7.39 years (mean ± SD) and 51.8% were males. We found that older age (≥ 85), polypharmacy, dyspnea, abnormal thorax computed tomography (CT), lower doses of anticoagulation, and high values of white blood cell, aspartate aminotransferase, C-reactive protein, lactate dehydrogenase, ferritin were associated with a significant increase in mortality ( P < 0.001 for all). Although all of these values were significant in multivariate logistic regression analysis, the most important ones were dyspnea (Odds ratio (OR) 57.916, 95% confidence interval (CI) 23.439–143.104, P < 0.001), polypharmacy (OR 6.782, 95% CI 3.082–14.927, P < 0.001), and thorax CT classification (typical; OR 9.633, 95% CI 2.511–37.122, P < 0.001). Conclusion Older age, polypharmacy, dyspnea, and abnormal thorax CT were the most significant mortality criteria and in addition appropriate anticoagulant use was associated with reduced mortality. Identifying the risk factors to predict mortality in older adults with COVID-19 is important to treat future cases successfully.

Attenuated initial serum ferritin concentration in critically ill coronavirus disease 2019 geriatric patients with comorbid psychiatric conditions

“…High ferritin is reported in severely ill geriatric COVID-19 non-survivors who were hospitalized ( n = 873) ( 105 ) or admitted to the ICU ( n = 174) ( 106 ). Similarly, high ferritin was associated with a 1.7-fold (HR 1.709, 95% CI 1.017–2.871, p = 0.043) higher risk of ICU admission or in-hospital death in a cohort of 362 elderly patients ( 107 ).…”

Characteristics, comorbidities and laboratory measures associated with disease severity and poor prognosis in young and elderly patients with COVID-19 admitted to medical wards in Emilia-Romagna region, Italy: a multicentre retrospective study

“…[17][18][19][20][21] The coexistence of comorbidities was also correlated with a more severe course and a higher risk of death in patients with SARS-CoV-2 infection. Immune-compromised patients, such as individuals with cancer or with persistent pathological conditions, as well as elderly subjects with several diseases, including diabetes, hypertension, cardiovascular disease, obesity, autoimmune diseases, chronic kidney/lung/liver diseases, dementia, solid organ transplant 22,23 are at higher risk to develop severe forms of COVID-19 with a potentially poor outcome in comparison to younger and healthier individuals. 24,25 SARS-CoV-2 infection may cause an impairment in the function of kidney and gastrointestinal tract, mainly in elderly people, [26][27] inducing fluid and electrolyte imbalances (such as hyper/hyponatremia, hypokalemia, hypocalcemia) in those subjects who undergo a higher probability of complications and even a more elevated risk of death.…”

Panorama das internações por covid-19 entre pessoas idosas residentes em Minas Gerais, Brasil

“…Pessoas idosas apresentam particularidades, como as alterações fisiológicas do processo de envelhecimento e a presença de doenças crônicas que explicam a gravidade clínica 8 e, consequentemente, a maior ocorrência de internações hospitalares por covid-19 nesse público 6,9 . que 88,8% 13 e 89,5% 14 das pessoas idosas internadas por covid-19 relataram comorbidades, sendo as mais comuns a hipertensão arterial sistêmica, o diabetes mellitus e as doenças cardiovasculares 12,13 .…”

“…A presença de alterações em exames laboratoriais 11,14,17 e de imagem [11][12][13][14][15] , além de desfechos adversos, como a demanda por suporte ventilatório [10][11][12][13] e óbito 11,14 , também são características identificadas em uma parcela das pessoas idosas internadas com a doença.…”

“…Apesar da existência de pesquisas que identificaram as características das internações por covid-19 em pessoas idosas [10][11][12][13][14][15] , o conhecimento ainda precisa ser ampliado em Minas Gerais, um dos estados com maiores índice de envelhecimento 19 e registros de casos da doença 20 .…”