Clinical Characteristics of Hospitalized Individuals Dying With COVID-19 by Age Group in Italy.

Age Factors Aged Betacoronavirus / isolation & purification COVID-19 Cardiovascular Diseases / diagnosis Cause of Death Comorbidity Coronavirus Infections / complications Dementia / diagnosis Female HIV Infections / diagnosis Humans Italy / epidemiology Kidney Failure, Chronic / diagnosis Male Middle Aged Mortality Pandemics Pneumonia, Viral / complications Prevalence Risk Factors SARS-CoV-2

COVID-19 Comorbidity Complications Elderly Mortality

Journal

The journals of gerontology. Series A, Biological sciences and medical sciences

ISSN: 1758-535X

Titre abrégé: J Gerontol A Biol Sci Med Sci

Pays: United States

ID NLM: 9502837

Informations de publication

Date de publication:
16 09 2020

Historique:

received: 03 05 2020

pubmed: 9 6 2020

medline: 29 9 2020

entrez: 8 6 2020

Statut: ppublish

Résumé

Aim of the present study is to describe characteristics of COVID-19-related deaths and to compare the clinical phenotype and course of COVID-19-related deaths occurring in adults (<65 years) and older adults (≥65 years). Medical charts of 3,032 patients dying with COVID-19 in Italy (368 aged < 65 years and 2,664 aged ≥65 years) were revised to extract information on demographics, preexisting comorbidities, and in-hospital complications leading to death. Older adults (≥65 years) presented with a higher number of comorbidities compared to those aged <65 years (3.3 ± 1.9 vs 2.5 ± 1.8, p < .001). Prevalence of ischemic heart disease, atrial fibrillation, heart failure, stroke, hypertension, dementia, COPD, and chronic renal failure was higher in older patients (≥65 years), while obesity, chronic liver disease, and HIV infection were more common in younger adults (<65 years); 10.9% of younger patients (<65 years) had no comorbidities, compared to 3.2% of older patients (≥65 years). The younger adults had a higher rate of non-respiratory complications than older patients, including acute renal failure (30.0% vs 20.6%), acute cardiac injury (13.5% vs 10.3%), and superinfections (30.9% vs 9.8%). Individuals dying with COVID-19 present with high levels of comorbidities, irrespective of age group, but a small proportion of deaths occur in healthy adults with no preexisting conditions. Non-respiratory complications are common, suggesting that the treatment of respiratory conditions needs to be combined with strategies to prevent and mitigate the effects of non-respiratory complications.

Sections du résumé

BACKGROUND

METHOD

Medical charts of 3,032 patients dying with COVID-19 in Italy (368 aged < 65 years and 2,664 aged ≥65 years) were revised to extract information on demographics, preexisting comorbidities, and in-hospital complications leading to death.

RESULTS

Older adults (≥65 years) presented with a higher number of comorbidities compared to those aged <65 years (3.3 ± 1.9 vs 2.5 ± 1.8, p < .001). Prevalence of ischemic heart disease, atrial fibrillation, heart failure, stroke, hypertension, dementia, COPD, and chronic renal failure was higher in older patients (≥65 years), while obesity, chronic liver disease, and HIV infection were more common in younger adults (<65 years); 10.9% of younger patients (<65 years) had no comorbidities, compared to 3.2% of older patients (≥65 years). The younger adults had a higher rate of non-respiratory complications than older patients, including acute renal failure (30.0% vs 20.6%), acute cardiac injury (13.5% vs 10.3%), and superinfections (30.9% vs 9.8%).

CONCLUSIONS

Individuals dying with COVID-19 present with high levels of comorbidities, irrespective of age group, but a small proportion of deaths occur in healthy adults with no preexisting conditions. Non-respiratory complications are common, suggesting that the treatment of respiratory conditions needs to be combined with strategies to prevent and mitigate the effects of non-respiratory complications.

Identifiants

DOI: 10.1093/gerona/glaa146 PMID: 32506122 PMC: PMC7314182

pubmed: 32506122

pii: 5854361

doi: 10.1093/gerona/glaa146

pmc: PMC7314182

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

1796-1800

Investigateurs

Luigi Palmieri (L)

Xanthi Andrianou (X)

Pierfrancesco Barbariol (P)

Antonino Bella (A)

Stefania Bellino (S)

Eva Benelli (E)

Luigi Bertinato (L)

Stefano Boros (S)

Gianfranco Brambilla (G)

Giovanni Calcagnini (G)

Marco Canevelli (M)

Maria Rita Castrucci (M)

Federica Censi (F)

Alessandra Ciervo (A)

Elisa Colaizzo (E)

Fortunato D'Ancona (F)

Martina Del Manso (M)

Chiara Donfrancesco (C)

Massimo Fabiani (M)

Francesco Facchiano (F)

Antonietta Filia (A)

Marco Floridia (M)

Fabio Galati (F)

Marina Giuliano (M)

Tiziana Grisetti (T)

Yllka Kodra (Y)

Martin Langer (M)

Ilaria Lega (I)

Cinzia Lo Noce (C)

Pietro Maiozzi (P)

Fiorella Malchiodi Albedi (F)

Valerio Manno (V)

Margherita Martini (M)

Alberto Mateo Urdiales (A)

Eugenio Mattei (E)

Claudia Meduri (C)

Paola Meli (P)

Giada Minelli (G)

Manuela Nebuloni (M)

Lorenza Nisticò (L)

Marino Nonis (M)

Graziano Onder (G)

Lucia Palmisano (L)

Nicola Petrosillo (N)

Patrizio Pezzotti (P)

Flavia Pricci (F)

Ornella Punzo (O)

Vincenzo Puro (V)

Valeria Raparelli (V)

Giovanni Rezza (G)

Flavia Riccardo (F)

Maria Cristina Rota (M)

Paolo Salerno (P)

Debora Serra (D)

Andrea Siddu (A)

Paola Stefanelli (P)

Manuela Tamburo De Bella (MT)

Dorina Tiple (D)

Brigid Unim (B)

Luana Vaianella (L)

Nicola Vanacore (N)

Monica Vichi (M)

Emanuele Rocco Villani (E)

Amerigo Zona (A)

Silvio Brusaferro (S)

Commentaires et corrections

Type : CommentIn