Clinical characteristics and prognostic factors in COVID-19 patients aged ≥80 years

Geriatr Gerontol Int. 2020 Jul;20(7):704-708. doi: 10.1111/ggi.13960. Epub 2020 Jun 9.

Abstract

Aim: The aim of the present study was to describe the clinical presentation of patients aged ≥80 years with coronavirus disease 2019 (COVID-19), and provide insights regarding the prognostic factors and the risk stratification in this population.

Methods: This was a single-center, retrospective, observational study, carried out in a referral center for COVID-19 in central Italy. We reviewed the clinical records of patients consecutively admitted for confirmed COVID-19 over a 1-month period (1-31 March 2020). We excluded asymptomatic discharged patients. We identified risk factors for death, by a uni- and multivariate Cox regression analysis. To improve model fitting and hazard estimation, continuous parameters where dichotomized by using Youden's index.

Results: Overall, 69 patients, aged 80-98 years, met the inclusion criteria and were included in the study cohort. The median age was 84 years (82-89 years is interquartile range); 37 patients (53.6%) were men. Globally, 14 patients (20.3%) presented a mild, 30 (43.5%) a severe and 25 (36.2%) a critical COVID-19 disease. A total of 23 (33.3%) patients had died at 30 days' follow up. Multivariate Cox regression analysis showed that severe dementia, pO2 ≤90 at admission and lactate dehydrogenase >464 U/L were independent risk factors for death.

Conclusions: The present data suggest that risk of death could be not age dependent in patients aged ≥80 years, whereas severe dementia emerged is a relevant risk factor in this population. Severe COVID-19, as expressed by elevated lactate dehydrogenase and low oxygen saturation at emergency department admission, is associated with a rapid progression to death in these patients. Geriatr Gerontol Int 2020; ••: ••-••.

Keywords: COVID-19; dementia; older adults; prognostic factors.

Publication types

  • Observational Study

MeSH terms

  • Aged, 80 and over
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Coronavirus Infections* / blood
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / mortality
  • Coronavirus Infections* / physiopathology
  • Critical Illness / epidemiology
  • Dementia / epidemiology*
  • Female
  • Humans
  • Hypoxia / epidemiology*
  • Italy / epidemiology
  • L-Lactate Dehydrogenase / blood*
  • Male
  • Mortality
  • Pandemics*
  • Pneumonia, Viral* / blood
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / mortality
  • Pneumonia, Viral* / physiopathology
  • Prognosis
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • L-Lactate Dehydrogenase