Clinical course and prognostic factors of COVID-19 infection in an elderly hospitalized population.

COVID-19 Elderly Mortality Pneumonia

Journal

Archives of gerontology and geriatrics
ISSN: 1872-6976
Titre abrégé: Arch Gerontol Geriatr
Pays: Netherlands
ID NLM: 8214379

Informations de publication

Date de publication:
27 Jul 2020
Historique:
received: 19 05 2020
revised: 07 07 2020
accepted: 23 07 2020
pubmed: 11 8 2020
medline: 11 8 2020
entrez: 11 8 2020
Statut: aheadofprint

Résumé

Older subjects have a higher risk of COVID-19 infection and a greater mortality. However, there is a lack of studies evaluating the characteristics of this infection at advanced age. We studied 404 patients ≥ 75 years (mean age 85.2 ± 5.3 years, 55 % males), with PCR-confirmed COVID-19 infection, attended in two hospitals in Madrid (Spain). Patients were followed-up until they were discharged from the hospital or until death. Symptoms started 2-7 days before admission, and consisted of fever (64 %), cough (59 %), and dyspnea (57 %). A total of 145 patients (35.9 %) died a median of 9 days after hospitalization. In logistic regression analysis, predictive factors of death were age (OR 1.086; 1.015-1.161 per year, p = 0.016), heart rate (1.040; 1.018-1.061 per beat, p < 0.0001), a decline in renal function during hospitalization (OR 7.270; 2.586-20.441, p < 0.0001) and worsening dyspnea during hospitalization (OR 73.616; 30.642-176.857, p < 0.0001). Factors predicting survival were a female sex (OR 0.271; 0.128-0.575, p = 0.001), previous treatment with RAAS inhibitors (OR 0.459; 0.222-0.949, p = 0.036), a higher oxygen saturation at admission (OR 0.901; 0.842-0.963 per percentage point increase, p = 0.002), and a greater platelet count (OR 0.995; 0.991-0.999 per 10 Elderly patients with COVID-19 infection have a similar clinical course to younger individuals. Previous treatment with RAAS inhibitors, and demographic, clinical and laboratory data influence prognosis.

Identifiants

pubmed: 32771883
pii: S0167-4943(20)30198-9
doi: 10.1016/j.archger.2020.104204
pmc: PMC7383171
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104204

Investigateurs

Rosa de Miguel (R)
Miriam Romero (M)
Mar Lago (M)
Cristina García-Quero (C)
Cristina Plaza (C)
Talía Sainz-Costa (T)
Susana Rivas-Vila (S)
Blanca Sánchez (B)
Celia García Torres (CG)
Lucía Martínez-Tobar (L)
María Hernandez-Pérez (M)
Pablo Racionero (P)
Patricia Mir-Ihara (P)
Jesús Peña-López (J)
Marta Bautista-Barea (M)
Alexa P Benítez (AP)
Pablo Rodríguez-Merlos (P)
María Barcenilla (M)
María San Basilio (MS)
María Valencia (M)
Ricardo Romero-Martín (R)
Ana Boto de Los Bueis (A)
Adriana de la Hoz-Polo (A)
María Del Pino-Cidad (M)
Javier Coca-Robinot (J)
Bárbara González-Ferrer (B)
Pedro Fernández-Pérez (P)
Isabel Mogollón (I)
María S Montoro-Romero (MS)
Isabel Villalaín (I)
Almudena Del Hierro-Zarzuelo (A)
Irene Hernández-Martín (I)
Javier Domínguez (J)
Alberto Luna (A)
Soledad Montoro (S)
Margarita Sánchez-Orgaz (M)
Gloria Amorena (G)
Cosme Lavín-Dapena (C)
Aaron Zapata Negreiros (AZ)

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors have no conflicts.

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Auteurs

Jose M Mostaza (JM)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain. Electronic address: josemaria.mostaza@salud.madrid.org.

Francisca García-Iglesias (F)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.

Teresa González-Alegre (T)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.

Francisco Blanco (F)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.

Marta Varas (M)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.

Clara Hernández-Blanco (C)

Hospital Cantoblanco, Madrid, Spain.

Victor Hontañón (V)

Hospital Cantoblanco, Madrid, Spain.

María J Jaras-Hernández (MJ)

Hospital Cantoblanco, Madrid, Spain.

Mónica Martínez-Prieto (M)

Hospital Cantoblanco, Madrid, Spain.

Araceli Menéndez-Saldaña (A)

Hospital Cantoblanco, Madrid, Spain.

María L Cachán (ML)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.

Eva Estirado (E)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.

Carlos Lahoz (C)

Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.

Classifications MeSH