Evaluation of risk scores as predictors of mortality and hospital length of stay for older COVID‐19 patients

Abstract

Three years after the first case of coronavirus disease 2019 , more than 500 million confirmed cases and more than 6 million deaths have been reported worldwide. 1 Immunodeficiency syndromes, comorbidities, frailty, and advanced age are risk factors for severe disease and mortality. 2 The case fatality rate has been reported as 8% in patients aged 70-79 years and 15% in those ≥80 years. 3 Initial clinical symptoms and key biochemical parameters have been associated with disease severity. Lymphopenia, elevated aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and D-dimer have been reported as useful mortality markers. 4 The MuLBSTA risk score, which considers multilobular infiltration, hypo-lymphocytosis, bacterial co-infection, smoking history, hypertension, and age, was developed for patients with viral pneumonia in the pre-COVID period. 5 The sensitivity of this score has since been demonstrated for patients with COVID-19, with a cutoff

COVID-19 and metabolic syndrome

“…Although prognostic markers unique to metabolic syndrome have not been defined, these individuals are likely to have higher perturbations of the above markers. Several prognostic calculators incorporating the clinical, radiological, haematological and biochemical factors have been designed and their use can facilitate triaging the at-risk patients for escalation of care [58] .…”

Effect of ultrasound‐guided thoracic paravertebral block on perioperative analgesia in elderly patients undergoing video‐assisted thoracic lobectomy in China: An interventional clinical randomized controlled trial

“…In addition, traditional pain management methods often cannot fully meet the individual needs of patients, resulting in poor analgesia or excessive analgesia. 7 Elderly patients are a special population who have obvious differences from young people in terms of physiology, psychology, tumor condition, and their surgical tolerance and risk: they have multiple chronic diseases such as hypertension, coronary heart disease, heart failure, chronic obstructive pulmonary disease, etc; [8][9][10] they are more prone to cognitive impairment, depression, anxiety and other psychological problems; their tumor biology behavior is more malignant; all these lead to the need for more safe, effective, accurate, and less traumatic intervention methods for anesthesia and perioperative management process of elderly patients. 2,4,6,11 Ultrasound-guided thoracic paravertebral block (UG-TPVB) is a technique that injects local anesthetics to the paravertebral space where the spinal nerves exit from the intervertebral foramen under ultrasound guidance, thereby producing unilateral (ipsilateral), segmental, somatic, and sympathetic nerve block in multiple adjacent thoracic dermatomes.…”

“…Elderly patients are a special population who have obvious differences from young people in terms of physiology, psychology, tumor condition, and their surgical tolerance and risk: they have multiple chronic diseases such as hypertension, coronary heart disease, heart failure, chronic obstructive pulmonary disease, etc; 8 , 9 , 10 they are more prone to cognitive impairment, depression, anxiety and other psychological problems; their tumor biology behavior is more malignant; all these lead to the need for more safe, effective, accurate, and less traumatic intervention methods for anesthesia and perioperative management process of elderly patients. 2 , 4 , 6 , 11…”

Do-Not-ResuscitateDecision-Making during the COVID-19 Pandemic in a Teaching Hospital: Lessons Learned for the Future

“…Each comorbidity is given a score of 1 (such as previous myocardial infarction), 2 (such as hemiplegia), 3 (such as moderate or severe liver disease), or 6 (such as malignant tumours) [ 14 ]. In COVID-19 patients, a CCI equal to or greater than 3 is associated with poor outcome [ 15 , 16 ]. The use of the CCI is widespread, especially in longitudinal studies, but has not been renewed since its creation in 1987 [ 17 , 18 ].…”