COVID-19: Clinical Presentation and Prognostic Factors of Severe Disease and Mortality in the Oldest-old Population. A Cohort Study.

Abstract

INTRODUCTIONThe oldest-old population (80 years or older) has the highest lethality from COVID-19. There is little information on the clinical presentation and specific prognostic factors for this group. This trial evaluated the clinical presentation and prognostic factors of severe disease and mortality in the oldest-old population.METHODSAmbispective cohort study of oldest-old patients hospitalized for respiratory infection associated with COVID-19 and with a positive test by real-time polymerase chain reaction. The clinical presentation and the factors associated with severe disease and mortality were evaluated (logistic regression). All patients were followed until discharge or death.RESULTSA total of 103 patients (59.2% female) were included. The most frequent symptoms were fever (68.9%), dyspnoea (60.2%), and cough (39.8%), and 11.7% presented confusion. Fifty-nine patients (57.3%) presented severe disease, and 59 died, with 43 patients (41.7%) presenting both of these. In the multivariate analysis, male sex (OR 0.31, 95% confidence interval [95% CI] 0.13-0.73, p 0.0074) and serum lactate dehydrogenase (LDH) (OR 2.55, 95% CI 1.21-5.37, p 0.0139) were associated with severe disease, and serum sodium was associated with mortality (OR 3.12, 95% CI 1.18-8.26, p 0.0222). No chronic disease or pharmacological treatment were associated with worse outcomes.CONCLUSIONSThe typical presenting symptoms of respiratory infection in COVID-19 are less frequent in the oldest-old population. Male sex and LDH level are predictors of severe disease, and serum sodium level predicts of mortality in this population.

COVID-19: Clinical Presentation and Prognostic Factors of Severe Disease and Mortality in the Oldest-Old Population: A Cohort Study

“…All authors read and approved the final manuscript. A preprint version of this article is available on Research Square [ 38 ].…”

Prognostic factors for mortality, ICU and hospital admission due to SARS-CoV-2: A systematic review and meta-analysis of cohort studies in Europe

“…As per our inclusion criteria, all cohort studies were based in Europe and included 23 studies from Spain (14, 16, 17, 22, 28, 29, 32, 33, 35, 50, 54, 57-59, 64, 67, 70, 80, 89, 92, 96, 97, 101), 22 studies from Italy(13, 19, 21, 23, 25, 30, 38, 39, 45, 47, 48, 55, 56, 61, 62, 68, 71, 77, 79, 90, 91, 93), 15 studies from France (20, 24, 27, 31, 40, 41, 43, 53, 60, 63, 65, 74, 76, 86, 99), ten studies from the UK (26, 34, 44, 49, 52, 66, 72, 75, 87, 98), four included patients from more than one country (69, 73, 88, 94), three from Germany (46, 51, 78), two studies from Sweden(36, 100), two from Denmark (42, 83) and one study from Belgium (81), Finland (5), the Netherlands (18), Norway (85) and Poland (37). The diagnosis of COVID-19 was made mainly with a PCR test, except for in five studies in which the diagnosis was made with the ICD Classification (20, 24, <...>…”