Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19
Víctor Manuel Becerra-Muñoz, Iván J Núñez-Gil, Charbel Maroun Eid, Marcos García Aguado, Rodolfo Romero, Jia Huang, Alba Mulet, Fabrizio Ugo, Francesco Rametta, Christoph Liebetrau, Alvaro Aparisi, Inmaculada Fernández-Rozas, María C Viana-Llamas, Gisela Feltes, Martino Pepe, Luis A Moreno-Rondón, Enrico Cerrato, Sergio Raposeiras-Roubín, Emilio Alfonso, Ana Carrero-Fernández, Luis Buzón-Martín, Mohammad Abumayyaleh, Adelina Gonzalez, Antonio Fernández Ortiz, Carlos Macaya, Vicente Estrada, Cristina Fernández-Pérez, Juan José Gómez-Doblas, Víctor Manuel Becerra-Muñoz, Iván J Núñez-Gil, Charbel Maroun Eid, Marcos García Aguado, Rodolfo Romero, Jia Huang, Alba Mulet, Fabrizio Ugo, Francesco Rametta, Christoph Liebetrau, Alvaro Aparisi, Inmaculada Fernández-Rozas, María C Viana-Llamas, Gisela Feltes, Martino Pepe, Luis A Moreno-Rondón, Enrico Cerrato, Sergio Raposeiras-Roubín, Emilio Alfonso, Ana Carrero-Fernández, Luis Buzón-Martín, Mohammad Abumayyaleh, Adelina Gonzalez, Antonio Fernández Ortiz, Carlos Macaya, Vicente Estrada, Cristina Fernández-Pérez, Juan José Gómez-Doblas
Abstract
Background: the coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and mortality, particularly in older patients.
Methods: post hoc analysis of the international, multicentre, 'real-world' HOPE COVID-19 registry. All patients aged ≥65 years hospitalised for COVID-19 were selected. Epidemiological, clinical, analytical and outcome data were obtained. A comparative study between two age subgroups, 65-74 and ≥75 years, was performed. The primary endpoint was all cause in-hospital mortality.
Results: about, 1,520 patients aged ≥65 years (60.3% male, median age of 76 [IQR 71-83] years) were included. Comorbidities such as hypertension (69.2%), dyslipidaemia (48.6%), cardiovascular diseases (any chronic heart disease in 38.4% and cerebrovascular disease in 12.5%), and chronic lung disease (25.3%) were prevalent, and 49.6% were on ACEI/ARBs. Patients aged 75 years and older suffered more in-hospital complications (respiratory failure, heart failure, renal failure, sepsis) and a significantly higher mortality (18.4 vs. 48.2%, P < 0.001), but fewer admissions to intensive care units (11.2 vs. 4.8%). In the overall cohort, multivariable analysis demonstrated age ≥75 (OR 3.54), chronic kidney disease (OR 3.36), dementia (OR 8.06), peripheral oxygen saturation at admission <92% (OR 5.85), severe lymphopenia (<500/mm3) (OR 3.36) and qSOFA (Quick Sequential Organ Failure Assessment Score) >1 (OR 8.31) to be independent predictors of mortality.
Conclusion: patients aged ≥65 years hospitalised for COVID-19 had high rates of in-hospital complications and mortality, especially among patients 75 years or older. Age ≥75 years, dementia, peripheral oxygen saturation <92%, severe lymphopenia and qSOFA scale >1 were independent predictors of mortality in this population.
Keywords: Coronavirus disease 2019; SARS-CoV-2; comorbidities; older adults.
© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Source: PubMed