Clinical Epidemiology and Ageing

Clinical Characteristics and Outcomes of 821 Older Patients With SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards.

Zerah L, Baudouin É, Pépin M, Mary M, Krypciak S, Bianco C, Roux S, Gross A, Toméo C, Lemarié N, Dureau A, Bastiani S, Ketz F, Boully C, de Villelongue C, Romdhani M, Desoutter M-A, Duron E, David J-P, Thomas C, Paillaud E, de Malglaive P, Bouvard E, Lacrampe M, Mercadier E, Monti A, Hanon O, Fossey-Diaz V, Bourdonnec L, Riou B, Vallet H, Boddaert J J Gerontol A Biol Sci Med Sci. 2021;76(3):e4-e12.

BACKGROUND: There is limited information describing the characteristics and outcomes of hospitalized older patients with confirmed coronavirus disease 2019 (COVID-19).

METHOD: We conducted a multicentric retrospective cohort study in 13 acute COVID-19 geriatric wards, from March 13 to April 15, 2020, in Paris area. All consecutive patients aged 70 years and older, with confirmed COVID-19, were enrolled.

RESULTS: Of the 821 patients included in the study, the mean (SD) age was 86 (7) years; 58% were female; 85% had ≥2 comorbidities; 29% lived in an institution; and the median [interquartile range] Activities of Daily Living scale (ADL) score was 4 [2-6]. The most common symptoms at COVID-19 onset were asthenia (63%), fever (55%), dyspnea (45%), dry cough (45%), and delirium (25%). The in-hospital mortality was 31% (95% confidence interval [CI] 27-33). On multivariate analysis, at COVID-19 onset, the probability of in-hospital mortality was increased with male gender (odds ratio [OR] 1.85; 95% CI 1.30-2.63), ADL score <4 (OR 1.84; 95% CI 1.25-2.70), asthenia (OR 1.59; 95% CI 1.08-2.32), quick Sequential Organ Failure Assessment score ≥2 (OR 2.63; 95% CI 1.64-4.22), and specific COVID-19 anomalies on chest computerized tomography (OR 2.60; 95% CI 1.07-6.46).

CONCLUSIONS: This study provides new information about older patients with COVID-19 who are hospitalized. A quick bedside evaluation at admission of sex, functional status, systolic arterial pressure, consciousness, respiratory rate, and asthenia can identify older patients at risk of unfavorable outcomes.

MeSH terms: Aged; Aged, 80 and over; COVID-19; Female; Geriatric Assessment; Hospital Mortality; Hospitalization; Humans; Male; Outcome Assessment, Health Care; Pandemics; Paris; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2
DOI: 10.1093/gerona/glaa210