Comorbidities as Risk Factors for Severe Disease in Hospitalized Elderly COVID-19 Patients by Different Age-Groups in Japan

Asai, Yasufumi; Nomoto, Hidetoshi; Hayakawa, Kayoko; Matsunaga, Nobuaki; Tsuzuki, Shinya; Terada, Mari; Ohtsu, Hiroshi; Kitajima, Koji; Suzuki, Kumiko; Suzuki, T.; Nakamura, Keiji; Morioka, Shigefumi; Saito, Sho; Saito, Fumitake; Ohmagari, Norio

doi:10.1159/000521000

Cited by 27 publications

(27 citation statements)

References 45 publications

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“…As suggested previously, older age, male sex, cardiovascular disease, chronic lung disease, and obesity are among the factors associated with severe COVID-19 [5,9,12,17,18]. In addition, these risk factors are similar to those specific to the elderly population [6].…”

Section: Discussionmentioning

confidence: 79%

“…These results are not in agreement with those of previous studies [22,23,31,32], and dementia itself would not intuitively seem to have a positive effect on the severity of COVID-19. However, two reports from Japan stated that dementia was not a significant risk factor for severe illness due to COVID-19 [6,33]. Examination of the reason for this discrepancy is a future challenge.…”

Section: Discussionmentioning

confidence: 99%

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Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults

Tsuzuki

Akiyama

Matsunaga

et al. 2022

Preprint

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BackgroundJapan is fast becoming an extremely aged society and older adults are known to be at risk of severe COVID-19. However, the impact of risk factors specific to this population for severe COVID-19 caused by the Omicron variant of concern (VOC) are not yet clear.MethodsWe performed an exploratory analysis using logistic regression to identify risk factors for severe COVID-19 illness among 4,868 older adults with a positive SARS-CoV-2 test result who were admitted to a healthcare facility between 1 January 2022 and 16 May 2022. We then conducted one-to-one propensity score (PS) matching for three factors—dementia, admission from a long-term care facility, and poor physical activity status—and used Fisher’s exact test to compare the proportion of severe COVID-19 cases in the matched data. We also estimated the average treatment effect on treated (ATT) in each PS matching analysis.ResultsOf the 4,868 cases analyzed, 1,380 were severe. Logistic regression analysis showed that age, male sex, cardiovascular disease, cerebrovascular disease, chronic lung disease, renal failure and/or dialysis, physician-diagnosed obesity, admission from a long-term care facility, and poor physical activity status were risk factors for severe disease. Vaccination and dementia were identified as factors associated with non-severe illness. The ATT for dementia, admission from a long-term care facility, and poor physical activity status was −0.04 (95% confidence interval −0.07, −0.01), 0.09 (0.06, 0.12), and 0.17 (0.14, 0.19), respectively.ConclusionsOur results suggest that poor physical activity status and living in a long-term care facility have a substantial impact on the risk of severe COVID-19 caused by the Omicron VOC, while dementia might be associated with non-severe illness.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults

Tsuzuki

Akiyama

Matsunaga

et al. 2022

Preprint

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“…Our current understanding of the SARS-CoV-2 infection clinical course is that this virus causes more morbidity and mortality in the age group beyond 50 as well. [9][10][11][12] An overall higher incidence of seropositive RA, seronegative RA and other unspeci ed RA was noted with greater age in both periods analyzed before and during the pandemic, most notable after the age of 50. RA incidence is already known to be increased after the age of 40 years in men and after menopause in women, with over 50% of patients being above 65-year-old at diagnosis [13].…”

Section: Discussionmentioning

confidence: 96%

The Impact of The COVID-19 Pandemic on The Incidence of Adult and Pediatric Inflammatory Arthritis

Alkilany

Phillips

Anthony

et al. 2022

Preprint

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Background The SARS-CoV-2 pandemic has impacted both adult and pediatric populations. There is evidence that patients developed more chronic autoimmune diseases after the onset of pandemic. In scientific meetings and reported case series there has been discussion about whether those patients with genetic tendency to develop rheumatologic illnesses started to develop illness at an increased rate due to SAR-CoV-2 viral induction of the host immune defense. Objective Our study objective was to determine whether the incidence of new onset rheumatologic diseases has increased with the COVID-19 pandemic, focusing on those that involve interferon type I pathway dysfunction, such as juvenile idiopathic arthritis and adult rheumatoid arthritis at the global level. Methods We used de-identified, aggregated data from the electronic health records (EHRs) of 65 global healthcare organizations, including over 60 million people, through the TriNetX platform. Deidentified data were queried and analyzed from the COVID-19 research network of TriNetX from October 2018 to July 2021 using simple chi-square statistics of independence. Results Our results showed that among the SARS-CoV-2 positive patients compared to SARS-COV-2 negative patient there is a significant increase in the incidence rate of new onset adult “seronegative RA”, “other unspecified RA” in all adult age groups, “seropositive RA” above 50-year-old age. And “other juvenile idiopathic arthritis” subgroup in the pediatric population. Conclusion The results of this study suggest that there might be an association of SARS-CoV-2 infection in the etiopathogenesis of some subtypes of childhood and adult rheumatoid arthritis. This association could be explained by dysregulation of type I interferon activation signaling pathways that play roles in the pathogenesis of autoimmune arthritis in these subgroups and seems to be more significant in the older patient age groups above 50 years.

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“…With regard to risk factor details, there is a possibility that the risk may be high in the elderly owing to frailty, and as a result, it was observed that the higher was the body weight, the higher was the risk [21,22]. It has been suggested that the low risk of mortality in Japanese people is associated with lifestyle habits such as obesity [7].…”

Section: Discussionmentioning

confidence: 99%

Predictive Model of Risk Factors of High Flow Nasal Cannula Using Machine Learning in COVID-19

Matsunaga

Kamata²,

Asai

et al. 2022

Preprint

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BackgroundWith the rapid increase in the number of COVID-19 patients in Japan, the number of patients receiving oxygen at home has also increased rapidly, and some of these patients have died. An efficient approach to identify high-risk patients with slowly progressing and rapidly worsening COVID-19, and to avoid missing the timing of therapeutic intervention will improve patient prognosis and prevent medical complications.MethodsPatients admitted to medical institutions in Japan from November 14, 2020 to April 11, 2021 and registered in the COVID-19 Registry Japan were included. Risk factors for patients with High Flow Nasal Cannula invasive respiratory management or higher were comprehensively explored using machine learning. Age-specific cohorts were created, and severity prediction was performed for the patient surge period and normal times, respectively.ResultsWe were able to obtain a model that was able to predict severe disease with a sensitivity of 57% when the specificity was set at 90% for those aged 40-59 years, and with a specificity of 50% and 43% when the sensitivity was set at 90% for those aged 60-79 years and 80 years and older, respectively. We were able to identify lactate dehydrogenase level (LDH) as an important factor in predicting the severity of illness in all age groups.DiscussionUsing machine learning, we were able to identify risk factors with high accuracy, and predict the severity of the disease. Using machine learning, we were able to identify risk factors with high accuracy, and predict the severity of the disease. We plan to develop a tool that will be useful in determining the indications for hospitalisation for patients undergoing home care and early hospitalisation.

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Comorbidities as Risk Factors for Severe Disease in Hospitalized Elderly COVID-19 Patients by Different Age-Groups in Japan

Cited by 27 publications

References 45 publications

Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults

Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults

The Impact of The COVID-19 Pandemic on The Incidence of Adult and Pediatric Inflammatory Arthritis

Predictive Model of Risk Factors of High Flow Nasal Cannula Using Machine Learning in COVID-19

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