Risk Factors for Mortality in 244 Older Adults With COVID-19 in Wuhan, China: A Retrospective Study.
Age Factors
Aged
Aged, 80 and over
Betacoronavirus
COVID-19
Case-Control Studies
China
/ epidemiology
Coronavirus Infections
/ mortality
Female
Hospital Mortality
Humans
Logistic Models
Male
Middle Aged
Pandemics
Patient Admission
/ statistics & numerical data
Patient Discharge
/ statistics & numerical data
Pneumonia, Viral
/ mortality
Prognosis
ROC Curve
Retrospective Studies
Risk Factors
SARS-CoV-2
COVID-19
mortalityolder patientsrisk factors
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
01
04
2020
revised:
07
04
2020
accepted:
14
04
2020
pubmed:
10
5
2020
medline:
3
7
2020
entrez:
9
5
2020
Statut:
ppublish
Résumé
Previous studies have reported that older patients may experience worse outcome(s) after infection with severe acute respiratory syndrome coronavirus-2 than younger individuals. This study aimed to identify potential risk factors for mortality in older patients with coronavirus disease 2019 (COVID-19) on admission, which may help identify those with poor prognosis at an early stage. Retrospective case-control. Fever ward of Sino-French New City Branch of Tongji Hospital, Wuhan, China. Patients aged 60 years or older with COVID-19 (n = 244) were included, of whom 123 were discharged and 121 died in hospital. Data retrieved from electronic medical records regarding symptoms, signs, and laboratory findings on admission, and final outcomes of all older patients with COVID-19, were retrospectively reviewed. Univariate and multivariate logistic regression analyses were used to explore risk factors for death. Univariate analysis revealed that several clinical characteristics and laboratory variables were significantly different (ie, P < .05) between discharged and deceased patients. Multivariable logistic regression analysis revealed that lymphocyte (LYM) count (odds ratio [OR] = 0.009; 95% confidence interval [CI] = 0.001-0.138; P = .001) and older age (OR = 1.122; 95% CI = 1.007-1.249; P = .037) were independently associated with hospital mortality. White blood cell count was also an important risk factor (P = .052). The area under the receiver operating characteristic curve in the logistic regression model was 0.913. Risk factors for in-hospital death were similar between older men and women. Older age and lower LYM count on admission were associated with death in hospitalized COVID-19 patients. Stringent monitoring and early intervention are needed to reduce mortality in these patients. J Am Geriatr Soc 68:E19-E23, 2020.
Sections du résumé
BACKGROUND/OBJECTIVES
OBJECTIVE
Previous studies have reported that older patients may experience worse outcome(s) after infection with severe acute respiratory syndrome coronavirus-2 than younger individuals. This study aimed to identify potential risk factors for mortality in older patients with coronavirus disease 2019 (COVID-19) on admission, which may help identify those with poor prognosis at an early stage.
DESIGN
METHODS
Retrospective case-control.
SETTING
METHODS
Fever ward of Sino-French New City Branch of Tongji Hospital, Wuhan, China.
PARTICIPANTS
METHODS
Patients aged 60 years or older with COVID-19 (n = 244) were included, of whom 123 were discharged and 121 died in hospital.
MEASUREMENTS
METHODS
Data retrieved from electronic medical records regarding symptoms, signs, and laboratory findings on admission, and final outcomes of all older patients with COVID-19, were retrospectively reviewed. Univariate and multivariate logistic regression analyses were used to explore risk factors for death.
RESULTS
RESULTS
Univariate analysis revealed that several clinical characteristics and laboratory variables were significantly different (ie, P < .05) between discharged and deceased patients. Multivariable logistic regression analysis revealed that lymphocyte (LYM) count (odds ratio [OR] = 0.009; 95% confidence interval [CI] = 0.001-0.138; P = .001) and older age (OR = 1.122; 95% CI = 1.007-1.249; P = .037) were independently associated with hospital mortality. White blood cell count was also an important risk factor (P = .052). The area under the receiver operating characteristic curve in the logistic regression model was 0.913. Risk factors for in-hospital death were similar between older men and women.
CONCLUSION
CONCLUSIONS
Older age and lower LYM count on admission were associated with death in hospitalized COVID-19 patients. Stringent monitoring and early intervention are needed to reduce mortality in these patients. J Am Geriatr Soc 68:E19-E23, 2020.
Identifiants
pubmed: 32383809
doi: 10.1111/jgs.16533
pmc: PMC7267277
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E19-E23Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 The American Geriatrics Society.
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