COVID-19 in Older Adults: A Series of 76 Patients Aged 85 Years and Older with COVID-19.
Aged, 80 and over
C-Reactive Protein
/ analysis
COVID-19
/ blood
Cohort Studies
Comorbidity
Female
France
/ epidemiology
Hospitalization
/ statistics & numerical data
Humans
Intensive Care Units
/ statistics & numerical data
Lymphocyte Count
/ methods
Male
Mortality
Outcome and Process Assessment, Health Care
Prognosis
Risk Factors
SARS-CoV-2
/ isolation & purification
Survival Analysis
Symptom Assessment
/ methods
COVID-19
SARS-CoV-2
clinical research
mortality
older adults
risk 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:
12 2020
12 2020
Historique:
received:
23
06
2020
revised:
04
10
2020
accepted:
05
10
2020
pubmed:
13
10
2020
medline:
29
12
2020
entrez:
12
10
2020
Statut:
ppublish
Résumé
Clinical presentation and risk factors of death in COVID-19 in oldest adults have not been well characterized. To describe clinical features and outcome of COVID-19 in patients older than 85 years and study risk factors for mortality. Prospective cohort. Patients aged 85 years and older, admitted in noncritical care units at the University Hospital Lariboisière Fernand-Widal (Paris, France) for confirmed severe acute respiratory syndrome coronavirus 2 infection were included and followed up for 21 days. Clinical and laboratory findings were collected. Cox survival analysis was performed to explore factors associated with death. From March 14 to April 11, 2020, 76 patients (median age = 90 (86-92) years; women = 55.3%) were admitted for confirmed COVID-19. Of the patients, 64.5% presented with three or more comorbidities. Most common symptoms were asthenia (76.3%), fever (75.0%) and confusion and delirium (71.1%). An initial fall was reported in 25.0% of cases, and digestive symptoms were reported in 22.4% of cases. COVID-19 was severe in 51.3% of cases, moderate in 32.9%, and mild in 15.8%. Complications included acute respiratory syndrome (28.9%), cardiac decompensation (14.5%), and hypotensive shock (9.0%). Fatality at 21 days was 28.9%, after a median course of disease of 13 (8-17) days. Males were overrepresented in nonsurvivors (68.2%). In survivors, median length of stay was 12 (9-19.5) days. Independent predictive factors of death were C-reactive protein level at admission and lymphocyte count at nadir. Specific clinical features, multiorgan injury, and high case fatality rate are observed in older adults with COVID-19. However, rapid diagnosis, appropriate care, and monitoring seem to improve prognosis.
Sections du résumé
BACKGROUND
Clinical presentation and risk factors of death in COVID-19 in oldest adults have not been well characterized.
OBJECTIVES
To describe clinical features and outcome of COVID-19 in patients older than 85 years and study risk factors for mortality.
DESIGN
Prospective cohort.
PARTICIPANTS AND SETTING
Patients aged 85 years and older, admitted in noncritical care units at the University Hospital Lariboisière Fernand-Widal (Paris, France) for confirmed severe acute respiratory syndrome coronavirus 2 infection were included and followed up for 21 days.
MEASUREMENTS
Clinical and laboratory findings were collected. Cox survival analysis was performed to explore factors associated with death.
RESULTS
From March 14 to April 11, 2020, 76 patients (median age = 90 (86-92) years; women = 55.3%) were admitted for confirmed COVID-19. Of the patients, 64.5% presented with three or more comorbidities. Most common symptoms were asthenia (76.3%), fever (75.0%) and confusion and delirium (71.1%). An initial fall was reported in 25.0% of cases, and digestive symptoms were reported in 22.4% of cases. COVID-19 was severe in 51.3% of cases, moderate in 32.9%, and mild in 15.8%. Complications included acute respiratory syndrome (28.9%), cardiac decompensation (14.5%), and hypotensive shock (9.0%). Fatality at 21 days was 28.9%, after a median course of disease of 13 (8-17) days. Males were overrepresented in nonsurvivors (68.2%). In survivors, median length of stay was 12 (9-19.5) days. Independent predictive factors of death were C-reactive protein level at admission and lymphocyte count at nadir.
CONCLUSION
Specific clinical features, multiorgan injury, and high case fatality rate are observed in older adults with COVID-19. However, rapid diagnosis, appropriate care, and monitoring seem to improve prognosis.
Identifiants
pubmed: 33045106
doi: 10.1111/jgs.16894
pmc: PMC7675559
doi:
Substances chimiques
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2735-2743Informations de copyright
© 2020 The American Geriatrics Society.
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