Table 4.
Differences in treatment, complications, and outcomes in Patients ≥ 80 Years Hospitalized with COVID-19 During the First and Successive Waves
|
Total
N (%) ( n = 5953) |
First wave
N (%) ( n = 4545) |
Successive waves
N (%) ( n = 1408) |
p value | |
|---|---|---|---|---|
| Immunomodulatory therapy | ||||
| Systemic corticosteroids | 2902 (49.0) | 1770 (39.2) | 1135 (80.6) | < 0.001 |
| Tocilizumab | 228(3.8) | 151 (3.3) | 77 (5.5) | < 0.001 |
| Colchicine | 68 (1.2) | 64 (1.4) | 4 (0.3) | < 0.001 |
| Anakinra | 31 (0.5) | 21 (0.5) | 10 (0.7) | 0.270 |
| Baricitinib | 26 (0.5) | 21 (0.6) | 5 (048) | 0.360 |
| Antivirals | ||||
| Hydroxychloroquine | 3467 (58.5) | 3463 (76.5) | 4 (0.3) | < 0.001 |
| Lopinavir/ritonavir | 1893 (31.9) | 1885 (41.7) | 8 (0.6) | < 0.001 |
| Interferon | 302 (5.1) | 302 (6.7) | 0 (0.0) | < 0.001 |
| Remdesivir | 165 (2.8) | 7 (0.2) | 158 (11.2) | < 0.001 |
| Chloroquine | 160 (2.7) | 160 (3.5) | 0 (0.0) | < 0.001 |
| Immunoglobulin | 10 (0.2) | 10 (0.2) | 0 (0.0) | 0.131 |
| Antibiotics | ||||
| Beta-lactams | 4300 (72.6) | 3307 (73.2) | 993 (70.7) | 0.064 |
| Quinolones | 942 (16.0) | 689 (15.3) | 253 (18.0) | 0.017 |
| Macrolides | 3060 (51.7) | 2522 (55.9) | 538 (33.3) | < 0.001 |
| Ventilatory therapy | ||||
| High-flow nasal cannula oxygen | 398(6.7) | 312 (6.9) | 86 (6.1) | 0.288 |
| Non-invasive mechanical ventilation | 249 (4.2) | 185 (4.1) | 64 (4.6) | 0.460 |
| Invasive mechanic ventilation | 70 (1.2) | 55 (1.2) | 15 (1.1) | 0.642 |
| Anticoagulant therapy | ||||
| Oral anticoagulants a | 428 (7.2) | 323 (7.2) | 105 (7.5) | 0.681 |
| Low-molecular-weight heparin | 425 (83.5) | 3678 (81.5) | 1247 (88.8) | < 0.001 |
| Complications | ||||
| ARDS, severe | 1932 (32.6) | 1613 (35.7) | 319 (22.7) | < 0.001 |
| Acute kidney failure | 1370 (23.1) | 1059 (23.4) | 311 (22.1) | 0.324 |
| Acute heart failure | 794 (13.4) | 560 (12.4) | 234 (16.6) | < 0.001 |
| Pneumonia | 795 (13.4) | 649 (14.3) | 146 (10.4) | < 0.001 |
| Multiple organ dysfunction syndrome | 529 (8.9) | 440 (9.7) | 89 (6.3) | < 0.001 |
| Sepsis | 450 (7.6) | 366 (8.1) | 84 (6.0) | 0.009 |
| Arrhythmia | 382 (6.4) | 283 (6.3) | 99 (7.0) | 0.297 |
| Shock | 229 (3.9) | 186 (4.1) | 43 (3.1) | 0.073 |
| Venous thromboembolism | 110 (1.9) | 79 (1.7) | 43 (3.1) | 0.172 |
| Acute coronary syndrome | 84 (1.4) | 63 (1.4) | 21 (1.2) | 0.270 |
| Stroke | 54 (0.9) | 43 (0.9) | 11 (0.8) | 0.562 |
| Myocarditis | 52 (0.9) | 37 (0.8) | 15 (1.1) | 0.381 |
| Intravascular coagulation | 61 (1.0) | 52 (1.1) | 9 (0.6) | 0.098 |
| Epileptic seizures | 44 (0.7) | 35 (0.8) | 9 (0.6) | 0.614 |
| Acute peripheral ischemic | 36 (0.6) | 30 (0.7) | 6 (0.4) | 0.315 |
| Outcomes | ||||
| Intensive care unit admission | 111 (1.9) | 81 (1.8) | 30 (1.1) | 0.400 |
| Readmission | 341 (5.9) | 227 (5.2) | 114 (8.1) | < 0.001 |
| Death | 2697 (41.8) | 2004 (44.1) | 693 (36.4) | < 0.001 |
| Days of hospitalization, median (IQR) | 14 (10–21) | 14 (9–21) | 14 (10–21) | 0.734 |
N (%) Number of cases (percentage), ARDS Acute respiratory distress syndrome, IQR Interquartile range:
aAnticoagulant therapy (dicumarin or direct anticoagulant)
Statistically significant differences are indicated in bold