tetano
Editor, Senior Moderator
Geriatr Gerontol Int
. 2020 Jun 9.
doi: 10.1111/ggi.13960. Online ahead of print.
Clinical Characteristics and Prognostic Factors in COVID-19 Patients Aged ≥80 Years
Marcello Covino[SUP] 1 [/SUP], Giuseppe De Matteis[SUP] 2 [/SUP], Michele Santoro[SUP] 1 [/SUP], Luca Sabia[SUP] 1 [/SUP], Benedetta Simeoni[SUP] 1 [/SUP], Marcello Candelli[SUP] 1 [/SUP], Veronica Ojetti[SUP] 1 3 [/SUP], Francesco Franceschi[SUP] 1 3 [/SUP]
Affiliations
Abstract
Aim: The aim of the present study was to describe the clinical presentation of patients aged ≥80 years with coronavirus disease 2019 (COVID-19), and provide insights regarding the prognostic factors and the risk stratification in this population.
Methods: This was a single-center, retrospective, observational study, carried out in a referral center for COVID-19 in central Italy. We reviewed the clinical records of patients consecutively admitted for confirmed COVID-19 over a 1-month period (1-31 March 2020). We excluded asymptomatic discharged patients. We identified risk factors for death, by a uni- and multivariate Cox regression analysis. To improve model fitting and hazard estimation, continuous parameters where dichotomized by using Youden's index.
Results: Overall, 69 patients, aged 80-98 years, met the inclusion criteria and were included in the study cohort. The median age was 84 years (82-89 years is interquartile range); 37 patients (53.6%) were men. Globally, 14 patients (20.3%) presented a mild, 30 (43.5%) a severe and 25 (36.2%) a critical COVID-19 disease. A total of 23 (33.3%) patients had died at 30 days' follow up. Multivariate Cox regression analysis showed that severe dementia, pO[SUB]2[/SUB] ≤90 at admission and lactate dehydrogenase >464 U/L were independent risk factors for death.
Conclusions: The present data suggest that risk of death could be not age dependent in patients aged ≥80 years, whereas severe dementia emerged is a relevant risk factor in this population. Severe COVID-19, as expressed by elevated lactate dehydrogenase and low oxygen saturation at emergency department admission, is associated with a rapid progression to death in these patients. Geriatr Gerontol Int 2020; ••: ••-••.
Keywords: COVID-19; dementia; older adults; prognostic factors.
. 2020 Jun 9.
doi: 10.1111/ggi.13960. Online ahead of print.
Clinical Characteristics and Prognostic Factors in COVID-19 Patients Aged ≥80 Years
Marcello Covino[SUP] 1 [/SUP], Giuseppe De Matteis[SUP] 2 [/SUP], Michele Santoro[SUP] 1 [/SUP], Luca Sabia[SUP] 1 [/SUP], Benedetta Simeoni[SUP] 1 [/SUP], Marcello Candelli[SUP] 1 [/SUP], Veronica Ojetti[SUP] 1 3 [/SUP], Francesco Franceschi[SUP] 1 3 [/SUP]
Affiliations
- PMID: 32516861
- DOI: 10.1111/ggi.13960
Abstract
Aim: The aim of the present study was to describe the clinical presentation of patients aged ≥80 years with coronavirus disease 2019 (COVID-19), and provide insights regarding the prognostic factors and the risk stratification in this population.
Methods: This was a single-center, retrospective, observational study, carried out in a referral center for COVID-19 in central Italy. We reviewed the clinical records of patients consecutively admitted for confirmed COVID-19 over a 1-month period (1-31 March 2020). We excluded asymptomatic discharged patients. We identified risk factors for death, by a uni- and multivariate Cox regression analysis. To improve model fitting and hazard estimation, continuous parameters where dichotomized by using Youden's index.
Results: Overall, 69 patients, aged 80-98 years, met the inclusion criteria and were included in the study cohort. The median age was 84 years (82-89 years is interquartile range); 37 patients (53.6%) were men. Globally, 14 patients (20.3%) presented a mild, 30 (43.5%) a severe and 25 (36.2%) a critical COVID-19 disease. A total of 23 (33.3%) patients had died at 30 days' follow up. Multivariate Cox regression analysis showed that severe dementia, pO[SUB]2[/SUB] ≤90 at admission and lactate dehydrogenase >464 U/L were independent risk factors for death.
Conclusions: The present data suggest that risk of death could be not age dependent in patients aged ≥80 years, whereas severe dementia emerged is a relevant risk factor in this population. Severe COVID-19, as expressed by elevated lactate dehydrogenase and low oxygen saturation at emergency department admission, is associated with a rapid progression to death in these patients. Geriatr Gerontol Int 2020; ••: ••-••.
Keywords: COVID-19; dementia; older adults; prognostic factors.