Clinical factors affecting short- and long-term mortality in older patients with COVID-19: a retrospective cohort study

Published: 8 March 2024
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The majority of fatal cases of SARS-CoV-2 was concentrated among older patients. We aimed at assessing risk factors contributing to mortality in this population. A retrospective study including 584 COVID-19 patients aged ≥80 years hospitalized between October 10th 2020 to May 4th 2021 at Ospedale di Circolo (Varese, Italy) and Ospedale Galmarini (Tradate, Italy) was conducted. Evaluation of risk factors associated with in-hospital mortality was the primary endpoint. 509 patients were considered. Median age was 86 [82-89] years. Almost half of the patients (n=241) suffered from ≥3 comorbidities. Overall in-hospital mortality was 39.7% (n=202). Age, chronic kidney disease (CKD), peripheral oxygen saturation at admission, and high-flow oxygen during hospital stay independently predicted in-hospital mortality. Overall mortality at 6 months was 57.8% (n=294) and increased with increasing age and number of comorbidities (P<0.05). Age, CKD, and dementia independently predicted 6-month mortality. Age and comorbidities predicted short- and long-term mortality in older patients (≥80 years). Stratification of patients according to age and comorbidities might provide critical information for a better management of elderly patients.

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Richards F, Kodjamanova P, Chen X, et al. Economic burden of COVID-19: a systematic review. Clinicoecon Outcomes Res 2022;14:293-307. DOI: https://doi.org/10.2147/CEOR.S338225
Rovetta A, Bhagavathula AS. The impact of COVID-19 on mortality in italy: retrospective analysis of epidemiological trends. JMIR Public Health Surveill 2022;8:e36022. DOI: https://doi.org/10.2196/36022
Dorrucci M, Minelli G, Boros S, et al. Excess mortality in Italy during the COVID-19 pandemic: assessing the differences between the first and the second wave, year 2020. Front Public Health 2021;9:669209. DOI: https://doi.org/10.3389/fpubh.2021.669209
Pilotto A, Azzini M, Cella A, et al. The multidimensional prognostic index (MPI) for the prognostic stratification of older inpatients with COVID-19: A multicenter prospective observational cohort study. Arch Gerontol Geriatr 2021;95:104415. DOI: https://doi.org/10.1016/j.archger.2021.104415
Marengoni A, Zucchelli A, Vetrano DL, et al. Beyond Chronological age: frailty and multimorbidity predict inhospital mortality in patients with Coronavirus disease 2019. J Gerontol A Biol Sci Med Sci 2021;76:e38-e45. DOI: https://doi.org/10.1093/gerona/glaa291
Hoogendijk EO, Stolz E, Oude Voshaar RC, et al. Trends in Frailty and Its Association With Mortality: Results From the Longitudinal Aging Study Amsterdam, 1995-2016. Am J Epidemiol 2021;190:1316-23. DOI: https://doi.org/10.1093/aje/kwab018
Gemes K, Talback M, Modig K, et al. Burden and prevalence of prognostic factors for severe COVID-19 in Sweden. Eur J Epidemiol 2020;35:401-9. DOI: https://doi.org/10.1007/s10654-020-00646-z
Izcovich A, Ragusa MA, Tortosa F, et al. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS One 2020;15:e0241955. DOI: https://doi.org/10.1371/journal.pone.0241955
Steinmeyer Z, Vienne-Noyes S, Bernard M, et al. Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes. Geriatrics (Basel) 2020;5. DOI: https://doi.org/10.3390/geriatrics5040065
Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005;173:489-95. DOI: https://doi.org/10.1503/cmaj.050051
Jung C, Flaatten H, Fjolner J, et al. The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study. Crit Care 2021;25:149. DOI: https://doi.org/10.1186/s13054-021-03653-y
Villar J, Ferrando C, Martinez D, et al. Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial. Lancet Respir Med 2020;8:267-76. DOI: https://doi.org/10.1016/S2213-2600(19)30417-5
Wynants L, Van Calster B, Collins GS, et al. Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal. BMJ 2020;369:m1328. DOI: https://doi.org/10.1136/bmj.m1328
Dadras O, SeyedAlinaghi S, Karimi A, et al. COVID-19 mortality and its predictors in the elderly: A systematic review. Health Sci Rep 2022;5:e657. DOI: https://doi.org/10.1002/hsr2.657
Regvat J, Osrajnik I, Fošnarič I. Overview of hospital care of elderly patients with coronavirus infection in COVID unit in Slovenia. Eur Respir J 2021;58:PA2156. DOI: https://doi.org/10.1183/13993003.congress-2021.PA2156
Leung C. Risk factors for predicting mortality in elderly patients with COVID-19: A review of clinical data in China. Mech Ageing Dev 2020;188:111255. DOI: https://doi.org/10.1016/j.mad.2020.111255
Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect 2020;80:e14-e8. DOI: https://doi.org/10.1016/j.jinf.2020.03.005
Li Q, Zhao C. A Review of the Current Status of Clinical Management of COVID-19 in the Elderly. Med Sci Monit 2021;27:e930278. DOI: https://doi.org/10.12659/MSM.930278
Liberale L, Badimon L, Montecucco F, et al. Inflammation, Aging, and Cardiovascular Disease: JACC Review Topic of the Week. J Am Coll Cardiol 2022;79:837-47. DOI: https://doi.org/10.1016/j.jacc.2021.12.017
Perrotta F, Corbi G, Mazzeo G, et al. COVID-19 and the elderly: insights into pathogenesis and clinical decisionmaking. Aging Clin Exp Res 2020;32:1599-608. DOI: https://doi.org/10.1007/s40520-020-01631-y
Potere N, Del Buono MG, Caricchio R, et al. Interleukin-1 and the NLRP3 inflammasome in COVID-19: Pathogenetic and therapeutic implications. EBioMedicine 2022;85:104299. DOI: https://doi.org/10.1016/j.ebiom.2022.104299
Bonaventura A, Vecchie A, Dagna L, et al. Endothelial dysfunction and immunothrombosis as key pathogenic mechanisms in COVID-19. Nat Rev Immunol 2021;21:319-29. DOI: https://doi.org/10.1038/s41577-021-00536-9
Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020;55. DOI: https://doi.org/10.1183/13993003.01227-2020
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5
Xu XW, Wu XX, Jiang XG, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020;368:m606. DOI: https://doi.org/10.1136/bmj.m606
Péterfi A, Meszaros A, Szarvas Z, et al. Comorbidities and increased mortality of COVID-19 among the elderly: A systematic review. Physiol Int 2022. DOI: https://doi.org/10.1556/2060.2022.00206
Bae S, Kim SR, Kim MN, et al. Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis. Heart 2021;107:373-80. DOI: https://doi.org/10.1136/heartjnl-2020-317901
Basile C, Combe C, Pizzarelli F, et al. Recommendations for the prevention, mitigation and containment of the emerging SARS-CoV-2 (COVID-19) pandemic in haemodialysis centres. Nephrol Dial Transplant 2020;35:737-41. DOI: https://doi.org/10.1093/ndt/gfaa069
Liu N, Sun J, Wang X, et al. The impact of dementia on the clinical outcome of COVID-19: a systematic review and meta analysis. J Alzheimers Dis 2020;78:1775-82. DOI: https://doi.org/10.3233/JAD-201016
Bianchetti A, Rozzini R, Guerini F, et al. Clinical presentation of COVID19 in dementia patients. J Nutr Health Aging 2020;24:560-2. DOI: https://doi.org/10.1007/s12603-020-1389-1
Wang H, Li T, Barbarino P, et al. Dementia care during COVID-19. Lancet 2020;395:1190-1. DOI: https://doi.org/10.1016/S0140-6736(20)30755-8
Falk Erhag H, Guethnadottir G, Alfredsson J, et al. The association between the clinical frailty scale and adverse health outcomes in older adults in acute clinical settings - a systematic review of the literature. Clin Interv Aging 2023;18:249-61. DOI: https://doi.org/10.2147/CIA.S388160
Zou Y, Han M, Wang J, et al. Predictive value of frailty in the mortality of hospitalized patients with COVID-19: a systematic review and meta-analysis. Ann Transl Med 2022;10:166. DOI: https://doi.org/10.21037/atm-22-274
Grasselli G, Greco M, Zanella A, et al. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Intern Med 2020;180:1345-55. DOI: https://doi.org/10.1001/jamainternmed.2020.3539
Andrei S, Valeanu L, Stefan MG, et al. Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort. J Clin Med 2022;11. DOI: https://doi.org/10.3390/jcm11061544

How to Cite

Pennella, B., Rotunno, F., Mercuri, M., Guerci, M., Molteni, M., Biancucci, M., Berton, C., Troian, F., Tripodi, P. M., Gilio, A., Milano, A., Dalla Gasperina, D., Dentali, F., Bonaventura, A., & Maresca, A. M. (2024). Clinical factors affecting short- and long-term mortality in older patients with COVID-19: a retrospective cohort study. Italian Journal of Medicine, 18(1). https://doi.org/10.4081/itjm.2024.1707

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