tetano
Editor, Senior Moderator
Int J Infect Dis
. 2021 Mar 12;S1201-9712(21)00239-3.
doi: 10.1016/j.ijid.2021.03.021. Online ahead of print.
Peculiar clinical presentation of COVID- 19 and predictors of mortality in the elderly: a Multicentre Retrospective Cohort Study
D F Bavaro[SUP] 1 [/SUP], L Diella[SUP] 2 [/SUP], C Fabrizio[SUP] 3 [/SUP], R Sulpasso[SUP] 2 [/SUP], I F Bottalico[SUP] 4 [/SUP], A Calamo[SUP] 5 [/SUP], C R Santoro[SUP] 3 [/SUP], G Brindicci[SUP] 2 [/SUP], G Bruno[SUP] 3 [/SUP], A Mastroianni[SUP] 6 [/SUP], G B Buccoliero[SUP] 3 [/SUP], S Carbonara[SUP] 5 [/SUP], S Lo Caputo[SUP] 4 [/SUP], T Santantonio[SUP] 4 [/SUP], L Monno[SUP] 2 [/SUP], G Angarano[SUP] 2 [/SUP], A Saracino[SUP] 2 [/SUP]
Affiliations
Abstract
Background: The spectrum of clinical manifestations of CoronaVirus Disease-19 (COVID-19) is not yet completely known. In elderly, mortality and extra-pulmonary involvement appear to be more frequent than expected.
Methods: A multicentric-retrospective-case-series of patients hospitalized between March 1[SUP]st[/SUP] and June 15[SUP]th[/SUP], 2020 with confirmed COVID-19 by RT-PCR testing on throat/nasopharyngeal swabs and age ?65 years was analysed. Based on the "Clinical Frailty Scale" (CFS), patients were classified into three groups according to the resulting score: 1-3 (group A), 4-6 (group B), 7-9 (group C).
Results: Overall, 206 patients were included. Crude mortality was 27%. According to CFS, on admission, 60 patients (29%) were assigned to group A, 60 (29%) to group B, and 86 (42%) to group C. The following features were significantly more frequent among group C patients in comparison with groups B and A: mental confusion (65% vs 33% vs 7%, respectively, p < .001), kidney failure (39% vs 22% vs 20%, p = .019), dehydration syndrome (55% vs 27% vs 13%, p < .001), electrolyte imbalance (54% vs 32% vs 25%, p = .001), and diabetic decompensation (22% vs 12% vs 7%, p = .026). By multivariable logistic regression model, male sex (aOR = 2.87, 95%CI = 1.15-7.18), CFS between 7 and 9 (aOR = 9.97, 95%CI = 1.82-52.99), dehydration at admission (aOR = 4.27, 95%CI = 1.72-10.57), and non-invasive/invasive ventilation (aOR = 4.88, 95%CI = 1.94-12-26) were independent predictors of death.
Conclusions: Elderly with a high CFS showed frequent extrapulmonary signsat admission, even in absence of lung involvement. These findings, along with a high CFS, predicted a significant risk of mortality.
Keywords: COVID-19; Elderly; Extrapulmonary Manifestations; Frailty; SARS-CoV-2.
. 2021 Mar 12;S1201-9712(21)00239-3.
doi: 10.1016/j.ijid.2021.03.021. Online ahead of print.
Peculiar clinical presentation of COVID- 19 and predictors of mortality in the elderly: a Multicentre Retrospective Cohort Study
D F Bavaro[SUP] 1 [/SUP], L Diella[SUP] 2 [/SUP], C Fabrizio[SUP] 3 [/SUP], R Sulpasso[SUP] 2 [/SUP], I F Bottalico[SUP] 4 [/SUP], A Calamo[SUP] 5 [/SUP], C R Santoro[SUP] 3 [/SUP], G Brindicci[SUP] 2 [/SUP], G Bruno[SUP] 3 [/SUP], A Mastroianni[SUP] 6 [/SUP], G B Buccoliero[SUP] 3 [/SUP], S Carbonara[SUP] 5 [/SUP], S Lo Caputo[SUP] 4 [/SUP], T Santantonio[SUP] 4 [/SUP], L Monno[SUP] 2 [/SUP], G Angarano[SUP] 2 [/SUP], A Saracino[SUP] 2 [/SUP]
Affiliations
- PMID: 33722685
- DOI: 10.1016/j.ijid.2021.03.021
Abstract
Background: The spectrum of clinical manifestations of CoronaVirus Disease-19 (COVID-19) is not yet completely known. In elderly, mortality and extra-pulmonary involvement appear to be more frequent than expected.
Methods: A multicentric-retrospective-case-series of patients hospitalized between March 1[SUP]st[/SUP] and June 15[SUP]th[/SUP], 2020 with confirmed COVID-19 by RT-PCR testing on throat/nasopharyngeal swabs and age ?65 years was analysed. Based on the "Clinical Frailty Scale" (CFS), patients were classified into three groups according to the resulting score: 1-3 (group A), 4-6 (group B), 7-9 (group C).
Results: Overall, 206 patients were included. Crude mortality was 27%. According to CFS, on admission, 60 patients (29%) were assigned to group A, 60 (29%) to group B, and 86 (42%) to group C. The following features were significantly more frequent among group C patients in comparison with groups B and A: mental confusion (65% vs 33% vs 7%, respectively, p < .001), kidney failure (39% vs 22% vs 20%, p = .019), dehydration syndrome (55% vs 27% vs 13%, p < .001), electrolyte imbalance (54% vs 32% vs 25%, p = .001), and diabetic decompensation (22% vs 12% vs 7%, p = .026). By multivariable logistic regression model, male sex (aOR = 2.87, 95%CI = 1.15-7.18), CFS between 7 and 9 (aOR = 9.97, 95%CI = 1.82-52.99), dehydration at admission (aOR = 4.27, 95%CI = 1.72-10.57), and non-invasive/invasive ventilation (aOR = 4.88, 95%CI = 1.94-12-26) were independent predictors of death.
Conclusions: Elderly with a high CFS showed frequent extrapulmonary signsat admission, even in absence of lung involvement. These findings, along with a high CFS, predicted a significant risk of mortality.
Keywords: COVID-19; Elderly; Extrapulmonary Manifestations; Frailty; SARS-CoV-2.