ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month mortality in older inpatients with Covid-19

Aging (Albany NY). 2020 Jun 23;12(12):11306-11313. doi: 10.18632/aging.103583. Epub 2020 Jun 23.

Abstract

Background: To assess factors associated with one-month mortality among older inpatients with Covid-19.

Results: The mean age was 78 ± 7.8 years, 55.5% were men, CT scan lung damage was observed in 76% of the patients (mild 23%, moderate 38%, extensive 22%, and severe 7%). The mortality rate was 26%. Dependency/Activities of Daily Living (ADL) score ≤ 5/6, D-Dimers, LDH, and no anticoagulation by reference for curative were independently associated with one-month mortality. A score derived from the multivariate model showed good calibration and very good discrimination (Harrell's C index [95%CI] = 0.83 [0.79-0.87]).

Conclusion: ADL-dependency, high serum levels of D-Dimers and LDH and the absence of anticoagulation were independently associated with one-month mortality among older inpatients with Covid-19.

Methods: 108 consecutive older inpatients aged 65 and over with Covid-19 confirmed by RT-PCR and/or typical CT chest scan were prospectively included in a French single-centre cohort study from March to April 2020. A systematic geriatric assessment was performed. Covariates were lymphocyte count, serum levels of albumin, C-Reactive Protein, D-Dimers and Lactate Dehydrogenase (LDH), anticoagulation level, and exposure to the hydroxychloroquine and azithromycin combined therapy. Cox uni- and multivariate proportional-hazard regressions were performed to identify predictors of one-month mortality.

Keywords: COVID-19; anticoagulation; geriatric assessment; mortality; predictive biomarkers.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Aging
  • Anticoagulants / blood
  • Betacoronavirus*
  • Biomarkers / blood
  • Coronavirus Infections / mortality*
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Humans
  • Inpatients
  • L-Lactate Dehydrogenase / blood*
  • Male
  • Pandemics
  • Pneumonia, Viral / mortality*
  • Risk Factors

Substances

  • Anticoagulants
  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • L-Lactate Dehydrogenase

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2