COVID-19 in older adults

Nanda, Aman; Vura, Naga Venkata Rama Krishna; Gravenstein, Stefan

doi:10.1007/s40520-020-01581-5

Cited by 116 publications

(106 citation statements)

References 16 publications

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“…During a median hospital stay of 15 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) days, 160 (46.6%) patients died (Additional table 1). All-cause mortality was higher in patients with increased admission cTnI (65 deaths/88 patients, 73.9% vs. 95 deaths/255 patients, 37.3%, p<0.001).…”

Section: Resultsmentioning

confidence: 99%

“…However, data about the value of cTn speci cally in elderly subjects admitted for COVID-19 are scarce. This lack of information is remarkable, considering the epidemiology of the SARS-CoV-2 pandemic, in which old individuals are the most affected and often need hospitalization [13,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…A second cTnI measurement within 48 hours from the rst one was available for a subset. The 60-year age cut-off was chosen according to the general agreement that ≥60 year-old COVID-19 patients represent a distinctive population with speci c features [12][13][14].…”

Section: Study Populationmentioning

confidence: 99%

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Prevalence and prognostic value of cardiac troponin in elderly patients hospitalized for COVID-19

Marzo

Biagio

Bona

et al. 2020

Preprint

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Background: Increases in cardiac troponin (cTn) in coronavirus disease 2019 (COVID-19) have been associated with worse prognosis. Nonetheless, data about the significance of cTn in elderly subjects with COVID-19 are lacking.Methods: From a registry of consecutive patients with COVID-19 admitted to a hub hospital in Italy from 25/02/2020 to 03/07/2020, we selected those ≥60 year-old and with cTnI measured within 3 days from the molecular diagnosis of SARS-CoV-2 infection. When available, a second cTnI value within 48 hours was also extracted. The relationship between increased cTnI and all-cause in-hospital mortality was evaluated by a Cox regression model and restricted cubic spline functions with three knots.Results: Of 343 included patients (median age 75.0 (68.0-83.0) years, 34.7% men), 88 (25.7%) had cTnI above the upper-reference limit (0.046 µg/L). Patients with increased cTnI had more comorbidities, greater impaired respiratory exchange and higher inflammatory markers on admission than those with normal cTnI. Furthermore, they died more (73.9% vs. 37.3%, p<0.001) over 15 (6-25) days of hospitalization. The association of elevated cTnI with mortality was confirmed by the adjusted Cox regression model (HR: 1.61, 95%CI: 1.06-2.52, p=0.039) and was linear until 0.3 µg/L, with a subsequent plateau. Of 191 (55.7%) patients with a second cTnI measurement, 49 (25.7%) had an increasing trend, which was not associated with mortality (univariate HR 1.39, 95%CI 0.87-2.22, p=0.265).Conclusions: In elderly COVID-19 patients, an initial increase in cTn is common and predicts a higher risk of death. Serial cTn testing may not confer additional prognostic information.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence and prognostic value of cardiac troponin in elderly patients hospitalized for COVID-19

Marzo

Biagio

Bona

et al. 2020

Preprint

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“…Clinical trials involving those with cognitive impairment face unique challenges during such crises [1]. These individuals depend on routine for optimal functioning, as well as access to health care, and supportive community engagement.…”

Section: Impact On Participant Safety and Engagementmentioning

confidence: 99%

“…The long-term effects are yet unknown, but scientists are studying the disease and searching for solutions. In geriatric clinical trials research, the problems presented by COVID-19 are multifaceted: older adults face increased risk of morbidity and mortality due to COVID-19, and so ongoing clinical trials that enroll geriatric participants have been disrupted, appropriately so, in light of these increased risks [1]. Yet, the interruption of ongoing trials may further increase risks to older adults as critical research on treatments for highly prevalent diseases and conditions is slowed or stopped.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and geriatric clinical trials research

et al. 2020

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Severity of RSV infection in Southern European elderly patients during two consecutive winter seasons (2017–2018)

Boattini

Almeida

Christaki

et al. 2021

Journal of Medical Virology

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In Europe, the respiratory syncytial virus (RSV) surveillance system is very heterogeneous and there is growing evidence of the importance of RSV infections resulting in hospitalization of elderly patients. The aim of this study was to assess the severity of RSV infection in the elderly living in the aged Southern European countries. We conducted a retrospective study of elderly patients ( ≥65‐year old) admitted for laboratory‐confirmed RSV infection in three tertiary hospitals in Portugal, Italy, and Cyprus over two consecutive winter seasons (2017–2018). Uni‐multivariable analyses were carried out to evaluate the effect of clinical variables on radiologically confirmed pneumonia, use of noninvasive ventilation (NIV), and in‐hospital death (IHD). A total of 166 elderly patients were included. Pneumonia was evident in 29.5%. NIV was implemented in 16.3%, length of stay was 11.8 ± 12.2 days, and IHD occurred in 12.1%. Multivariable analyses revealed that the risk of pneumonia was higher in patients with chronic kidney disease (CKD) (odds ratio [OR]: 2.57; 95% confidence interval [CI]: 1.12–5.91); the use of NIV was higher in patients with obstructive sleep apnea or obesity hypoventilation syndrome (OSA or OHS) (OR: 5.38; 95% CI: 1.67–17.35) and CKD (OR: 2.52; 95% CI: 1.01–6.23); the risk of IHD was higher in males (OR: 3.30; 95% CI: 1.07–10.10) and in patients with solid neoplasm (OR: 9.06; 95% CI: 2.44–33.54) and OSA or OHS (OR: 8.39; 95% CI: 2.14–32.89). Knowledge of factors associated with RSV infection severity may aid clinicians to set priorities and reduce disease burden. Development of effective antiviral treatment and vaccine against RSV is highly desirable.

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COVID-19 in older adults

Cited by 116 publications

References 16 publications

Prevalence and prognostic value of cardiac troponin in elderly patients hospitalized for COVID-19

Prevalence and prognostic value of cardiac troponin in elderly patients hospitalized for COVID-19

COVID-19 and geriatric clinical trials research

Severity of RSV infection in Southern European elderly patients during two consecutive winter seasons (2017–2018)

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