Clinical presentation and outcome across age categories among patients with COVID-19 admitted to a Spanish Emergency Department

Martín‐Sánchez, Francisco Javier; Toro, Enrique Del; Cardassay, Eduardo; Carbó, Adrián Valls; Cuesta, Federico; Vigara, Marta; Gil, Pedro; Picado, Amanda López; Martínez-Valero, Carmen; Miranda, Juan de Dios; Lopez-Ayala, Pedro; Chaparro, David; López, Gabriel Cozar; Suárez-Cadenas, María Del Mar; Fernández, Pablo Jerez; Angós, Beatriz; Arco, Cristina Díaz del; Adrada, Esther Rodríguez; Moraleda, María Teresa Montalvo; Paeres, Carolina Espejo; Alonso, Cesáreo Fernández; Lerma, Carlos; Chacón, Ana; Briñón, Miguel Ángel García; Rueda, José Luis Fernández; Ortega, Luís; Fernández-Pérez, Cristina; Armengol, Juan Jorge González; Castillo, Juan González del

doi:10.1007/s41999-020-00359-2

Cited by 57 publications

(48 citation statements)

References 35 publications

(48 reference statements)

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“…These findings are consistent with similar clinical series from China [23,28]. Still, they are discordant with the conclusions of the Martín-Sanchez, et al study [29], where advanced age predicted not being admitted at the ICU. These findings from the Spain series may also have .…”

Section: Discussionsupporting

confidence: 89%

Clinical course and severity outcome indicators among COVID-19 hospitalized patients in relation to comorbidities distribution: Mexican cohort

Mexico

Carrillo

Méndez-Domínguez

et al. 2020

Preprint

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Introduction: COVID-19 affected worldwide, causing to date, around 500,000 deaths. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death rates depend mainly on the patients' comorbidities and age. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study's objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes. Materials and Methods: Retrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations. Dependent variables were four possible severity outcomes: (a) pneumonia, (b) mechanical ventilation (c) intensive care unit, and (d) death; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male. Hospital mortality among patients aged<15 was 9.11%, 51.99% of those aged >65 died. Male gender and increasing age predicted every severity outcome. Diabetes and hypertension predicted every severity outcome significantly. Obesity did not predict mortality, but CKD, respiratory diseases, cardiopathies were significant predictors. Conclusion: Obesity increased the risk for pneumonia, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death. Patients with respiratory diseases were less prone to develop pneumonia, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death.

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Section: Discussionsupporting

confidence: 89%

Clinical course and severity outcome indicators among COVID-19 hospitalized patients in relation to comorbidities distribution: Mexican cohort

Mexico

Carrillo

Méndez-Domínguez

et al. 2020

Preprint

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“…This study summarizes the clinical, biological and radiological characteristics, evolution and prognostic factors of patients with COVID-19 disease in primary and community healthcare. To date, we are aware of three published Spanish studies [ 10 – 12 ]. The first reported data from 48 patients on ICU admissions in a region where the pandemic was reported early [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona

et al. 2020

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Background In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. Aim To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Design and setting Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000. Method Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction. Logistic multivariate regression models adjusted for age and sex were constructed to analyse independent predictive factors associated with death, ICU admission and hospitalization. Results We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged � 65 years): 123 (38.2) were health workers (doctors, nurses, auxiliaries

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“…Although COVID-19 may affect individuals from all ages, elderly population is disproportionately impacted by the pandemic. Hospitalization and mortality rates increase drastically after 65 years of age (Centers for Disease Control and Prevention, 2020; Goujon et al, 2020) and current evidence points to age along with male sex and the presence of comorbid medical conditions as factors of poor prognosis and higher risk of death (Lu et al, 2020;Martin-Sanchez et al, 2020;Williamson et al, 2020). Moreover, elderly people with chronic diseases such as dementia often present atypical symptoms at onset of COVID-19 such as altered mental status (including confusion, agitation, disorientation, refusal of care, disorientation, and loss of appetite) (Bianchetti et al, 2020;Isaia et al, 2020;Ward et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Alonso‐Lana

Marquié

Ruiz

et al. 2020

Front. Aging Neurosci.

147

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The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide and has had unprecedented effects in healthcare systems, economies and society. COVID-19 clinical presentation primarily affects the respiratory system causing bilateral pneumonia, but it is increasingly being recognized as a systemic disease, with neurologic manifestations reported in patients with mild symptoms but, most frequently, in those in a severe condition. Elderly individuals are at high risk of developing severe forms of COVID-19 due to factors associated with aging and a higher prevalence of medical comorbidities and, therefore, they are more vulnerable to possible lasting neuropsychiatric and cognitive impairments. Several reports have described insomnia, depressed mood, anxiety, post-traumatic stress disorder and cognitive impairment in a proportion of patients after discharge from the hospital. The potential mechanisms underlying these symptoms are not fully understood but are probably multifactorial, involving direct neurotrophic effect of SARS-CoV-2, consequences of long intensive care unit stays, the use of mechanical ventilation and sedative drugs, brain hypoxia, systemic inflammation, secondary effects of medications used to treat COVID-19 and dysfunction of peripheral organs. Chronic diseases such as dementia are a particular concern not only because they are associated with higher rates of hospitalization and mortality but also because COVID-19 further exacerbates the vulnerability of those with cognitive impairment. In patients with dementia, COVID-19 frequently has an atypical presentation with mental status changes complicating the early identification of cases. COVID-19 has had a dramatical impact in long-term care facilities, where rates of infection and mortality have been very high. Community measures implemented to slow the spread of the virus have forced to social distancing and cancelation of cognitive stimulation programs, which may have contributed to generate loneliness, behavioral symptoms and worsening of cognition in patients with dementia. COVID-19 has impacted the functioning of Memory Clinics, research programs and clinical trials in the Alzheimer's field, triggering the

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Clinical presentation and outcome across age categories among patients with COVID-19 admitted to a Spanish Emergency Department

Cited by 57 publications

References 35 publications

Clinical course and severity outcome indicators among COVID-19 hospitalized patients in relation to comorbidities distribution: Mexican cohort

Clinical course and severity outcome indicators among COVID-19 hospitalized patients in relation to comorbidities distribution: Mexican cohort

Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

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