ISSN: 2657-7941
Archives of Medical Science - Aging
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1/2021
vol. 4
 
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abstract:
Clinical research

Coronavirus disease 2019 (COVID-19) in older patients: outcomes and risks of mortality

Christopher Nabors
1
,
Abhinaya Sridhar
1
,
Wilbert S. Aronow
1
,
Urvashi Hooda
1
,
Lawrence Huang
1
,
Merita Shehu
1
,
Melissa Gennarelli
1
,
Stephen A. Lobo
1
,
Abhay Dhand
1

1.
Department of Medicine, Westchester Medical Center, Valhalla, US
Arch Med Sci Aging 2021; 4: e33–e41
Online publish date: 2021/12/30
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Introduction
To understand how age and other factors impacted outcomes, we examined characteristics of patients aged 65 years and older hospitalized with COVID-19.

Material and methods
This was a retrospective cohort study that included all patients aged 65 years and older with laboratory-confirmed COVID-19, who were admitted to a suburban New York academic medical centre between 15 March and 13 May 2020, and discharged.

Results
Of 196 patients, the median age was 76 years, with 57% male, and 66% white. A greater proportion of “older” (77–105 years) compared to “old” (65–76 years) patients were admitted with a primary diagnosis other than COVID-19 (34% vs. 15%), were afebrile (80% vs. 67%), and had a clear initial chest X-ray (19% vs. 8%). Older patients had a higher prevalence of dementia (26% vs. 1.0%), cardiac (42% vs. 28%), and vascular disease (20% vs. 9%). Overall survival was lower among older compared to old patients (55% vs. 74%, p = 0.026) and when mechanical ventilation (20% vs. 46%, p = 0.29) or vasopressors (15% vs. 41%, p = 0.46) were required (20% vs. 46%, p = 0.029) and when new hepatic dysfunction (24% vs. 65%, p < 0.001) or new renal failure (29% vs. 56%, p = 0.015) developed. Factors at presentation that were associated with significantly lower survival included hypoxaemia, elevation of total white blood cell count, procalcitonin, and d-dimer.

Conclusions
Overall mortality was 34%. Survival was 2- to 3-fold higher for those aged 65–76 years compared to those aged 77 years and older who required advanced therapies such as mechanical ventilation. Improving clinical parameters were associated with significantly higher survival, regardless of age.

keywords:

COVID-19, coronavirus, aging, pandemic

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