The SARS-CoV-2 tendency to affect the older individuals more severely, raises the need for a concise summary isolating this age population. Analysis of clinical features in light of most recently published data allows for improved understanding, and better clinical judgement. A thorough search was performed to collect all articles published from 1st of January to 1st of June 2020, using the keywords COVID-19 and SARS-CoV-2 followed by the generic terms elderly, older adults or older individuals. The quality assessment of studies and findings was performed by an adaptation of the STROBE statement and CERQual approach. Excluding duplicates, a total of 1598 articles were screened, of which 20 studies were included in the final analysis, pertaining to 4965 older COVID-19 patients (≥60 years old). Variety in symptoms was observed, with fever, cough, dyspnea, fatigue, or sputum production being the most common. Prominent changes in laboratory findings consistently indicated lymphopenia and inflammation and in some cases organ damage. Radiological examination reveals ground glass opacities with occasional consolidations, bilaterally, with a possible peripheral tendency. An evident fraction of the elderly population (25.7%) developed renal injury or impairment as a complication. Roughly 71.4% of the older adults require supplementary oxygen, while invasive mechanical ventilation was required in almost a third of the reported hospitalized older individuals. In this review, death occurred in 20.0% of total patients with a recorded outcome (907/4531). Variability in confidence of findings is documented. Variety in symptom presentation is to be expected, and abnormalities in laboratory findings are present. Risk for mortality is evident, and attention to the need for supplementary oxygen and possible mechanical ventilation is advised. Further data is required isolating this age population. Presented literature may allow for the construction of better predictive models of COVID-19 in older populations.

The older population is one of the most vulnerable to experience adverse outcomes of COVID-19. Exploring different clinical features that may act as detrimental to this population’s survival is pivotal for recognizing the highest risk individuals for poor outcome. We thus aimed to characterize the clinical differences between 60-day survivors and non-survivors, as well as analyze variables influencing survival in the first older adults hospitalized in Poznan, Poland, with COVID-19. Symptoms, comorbidities, complications, laboratory results, and functional capacity regarding the first 50 older patients (≥60 years) hospitalized due to COVID-19 were retrospectively studied. Functional status before admission (dependent/independent) was determined based on medical history. The 60-day survivors (n = 30/50) and non-survivors (n = 20/50) were compared across clinical parameters. The patients had a mean age of 74.8 ± 9.4 years. Overall, 20/50 patients died during hospitalization, with no further fatal outcomes reported during the 60-day period. The non-survivors were on average older (78.3 ± 9.7 years), more commonly experienced concurrent heart disease (75%), and displayed functional dependence (65%) (p < 0.05). When assessing the variables influencing survival (age, heart disease, and functional dependence), using a multivariate proportional hazards regression, functional dependence (requiring assistance in core activities of daily living) was the main factor affecting 60-day survival (HR, 3.34; 95% CI: 1.29–8.63; p = 0.01). In our study, functional dependence was the most important prognostic factor associated with mortality. Elderly with COVID-19 who required assistance in core activities of daily living prior to hospitalization had a three times increased risk to experience mortality, as compared to those with complete independence. Exploring geriatric approaches, such as assessment of functional capacity, may assist in constructing comprehensive survival prognosis in the elderly COVID-19 population.

Background/introduction Intraventricular hemorrhage (IVH) is a dangerous complication facing a significant proportion of preterm infants. It is multifactorial in nature, and an observed fibronectin deficiency in the germinal matrix basal lamina is among the most prominent factors that influence such rupture. Better understanding of the FN1 gene polymorphisms and their role in IVH may further clarify the presence of a genetic susceptibility of certain babies to this complication. The aim of this study was to assess if 5 single nucleotide polymorphisms of the fibronectin gene may be linked to an increased incidence of IVH. Material and methods The study included 108 infants born between 24 and 32 weeks of gestation. IVH was diagnosed using cranial ultrasound performed on the 1st,3rd, and 7th day after birth and classified according to Papile et al. IVH classification. The 5 FN1 gene polymorphisms assessed in the study were the following: rs3796123; rs1968510; rs10202709; rs6725958; and rs35343655. Results IVH developed in 51 (47.2%) out of the 108 preterm infants. This includes, 18 (35.3%) with stage I IVH, 19 (37.3%) with stage II, 11 (21.6%) with stage III, and 3 (5.9%) with stage IV IVH. Incidence of IVH was higher in infants with lower APGAR scores, low gestational age, and low birthweight. Analysis showed that IVH stage II to IV was approximately seven times more likely to occur in infants with the genotype TT FN1 rs10202709 (OR 7237 (1046-79.59; p = 0,044)). No other significant association was found with the rest of the polymorphisms. Conclusion The results of our study indicate a sevenfold increased genetic susceptibility to IVH in preterm infants with the TT FN1 rs10202709 gene polymorphism. The fibronectin gene polymorphism may therefore be of crucial importance as a genetic risk factor for IVH in preterm infants. Further studies are warranted.

published from January 1st to 27th of December 2020. Two independent reviewers evaluated studies using the STROBE statement in combination with the CERQual quality assessment of findings. Total 1387 articles were screened and a final 24 studies evaluated (220 1st/2nd trimesters COVID-19 pregnant women). 132/220 (60%) were symptomatic, most commonly with fever (86/220=39%) or cough (73/220=33%). Minority of studies reported complications, notably preeclampsia (2/15 patients-13%). 3 cases of maternal death were reported. Majority of neonates had unreported status concerning the outcome of pregnancy. Neonatal death occurred in 17 cases (including one chemical pregnancy, 5 miscarriages, 2 IUFD, 6 stillbirths and 3 abortions) Majority of reported mothers who contracted COVID-19 during 1st/2nd trimesters are yet to complete their pregnancy. Usually, mothers are discharged from the hospital without any serious complications, however, placental inflammation/fibrin deposition and neonatal death has been reported in a number of cases.

Sepsis in neonates carries a high morbidity and mortality rate and is among the most feared complications in the neonatal intensive care unit (NICU). Catheter-related bloodstream infections (CRBSI) are a common etiology of late-onset sepsis. The aim of this study was to compare risk factors and characteristics between patients according to the type of catheter that was utilized and according to birth weight classification. The study included 51 newborns with confirmed CRBSI, which were hospitalized in our level 3 NICU between January 2017 and December 2018. The study population was stratified according to the type of venous catheter utilized (peripherally inserted central catheter, central venous catheter (CVC), and peripheral venous catheter). Infants with low birth weight and those who required prolonged parenteral nutrition were most likely to develop CRBSI in our study group. The type of venous catheter was not associated with blood culture results. Also, infants with a birth weight of < 1500 g and > 1500 g did not differ in sepsis etiology. Further research is required to assess venous catheters relative risk of causing sepsis and if the outcome can be traced back specifically to catheter type or patient characteristics.