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Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2020 Nov 17:afaa258. doi: 10.1093/ageing/afaa258

Clinical profile and predictors of in-hospital mortality among older patients admitted for COVID-19

Víctor Manuel Becerra-Muñoz 1,✉,2, Iván J Núñez-Gil 2,2, Charbel Maroun Eid 3, Marcos García Aguado 4, Rodolfo Romero 5, Jia Huang 6, Alba Mulet 7, Fabrizio Ugo 8, Francesco Rametta 9, Christoph Liebetrau 10, Alvaro Aparisi 11, Inmaculada Fernández-Rozas 12, María C Viana-Llamas 13, Gisela Feltes 14, Martino Pepe 15, Luis A Moreno-Rondón 16, Enrico Cerrato 17, Sergio Raposeiras-Roubín 18, Emilio Alfonso 19, Ana Carrero-Fernández 20, Luis Buzón-Martín 21, Mohammad Abumayyaleh 22,23, Adelina Gonzalez 24, Antonio Fernández Ortiz 25, Carlos Macaya 26, Vicente Estrada 27, Cristina Fernández-Pérez 28, Juan José Gómez-Doblas 29, On behalf of HOPE COVID-19 investigators
PMCID: PMC7717146  PMID: 33201181

Abstract

Background

The coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and mortality, particularly in older patients.

Methods

Post-hoc analysis of the international, multicentre, “real-world” HOPE COVID-19 registry. All patients aged ≥65 years hospitalised for COVID-19 were selected. Epidemiological, clinical, analytical and outcome data were obtained. A comparative study between two age subgroups, 65–74 and ≥75 years, was performed. The primary endpoint was all cause in-hospital mortality.

Results

1,520 patients aged ≥65 years (60.3% male, median age of 76 [IQR 71–83] years) were included. Comorbidities such as hypertension (69.2%), dyslipidemia (48.6%), cardiovascular diseases (any chronic heart disease in 38.4% and cerebrovascular disease in 12.5%), and chronic lung disease (25.3%) were prevalent, and 49.6% were on ACEI/ARBs. Patients aged 75 years and older suffered more in-hospital complications (respiratory failure, heart failure, renal failure, sepsis) and a significantly higher mortality (18.4 vs. 48.2%, P < 0.001), but fewer admissions to intensive care units (11.2 vs. 4.8%). In the overall cohort, multivariable analysis demonstrated age ≥75 (OR 3.54), chronic kidney disease (OR 3.36), dementia (OR 8,06), peripheral oxygen saturation at admission <92% (OR 5.85), severe lymphopenia (<500/mm3) (OR 3.36) and qSOFA (Quick Sequential Organ Failure Assessment Score) >1 (OR 8.31) to be independent predictors of mortality.

Conclusion

Patients aged ≥65 years hospitalised for COVID-19 had high rates of in-hospital complications and mortality, especially among patients 75 years or older. Age ≥75 years, dementia, peripheral oxygen saturation <92%, severe lymphopenia and qSOFA scale >1 were independent predictors of mortality in this population.

Keywords: Coronavirus disease 2019, SARS-CoV-2, older adults, comorbidities


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