Factors affecting mortality in geriatric patients hospitalized with COVID-19

Abstract

Background/aim We aimed to investigate the factors affecting the mortality of patients aged 65 years or older who were hospitalized with the diagnosis of new coronavirus pneumonia (COVID-19). Materials and methods This is a retrospective study of patients 65 years old or older with COVID-19 who were hospitalized in İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty Hospital, between March 11 and May 28, 2020. Demographic, clinical, treatment, and laboratory data were extracted from electronic medical records. We used univariate and multivariate logistic regression methods to explore the risk factors for in-hospital death. Results A total of 218 patients (112 men, 106 women) were included, of whom 166 were discharged and 52 died in hospital. With univariate analysis, various clinical features and laboratory variables were found to be significantly different (i.e. P < 0.05). In multivariate logistic regression analysis the following were independently associated with mortality: present malignancy [odds ratio (OR) = 4.817, 95% confidence interval (CI) = 1.107–20.958, P: 0.036]; dyspnea (OR = 4.652, 95% CI = 1.473–14.688, P: 0.009); neutrophil/lymphocyte ratio (NLR; OR = 1.097, 95% CI = 1.012–1.188, P: 0.025); the highest values of C-reactive protein (CRP; OR = 1.006, 95% CI = 1.000–1.012, P: 0.049), lactate dehydrogenase (LDH; OR = 1.002, 95% CI = 1.001–1.004, P: 0.003), and creatinine levels (OR = 1.497, 95% CI = 1.126–1.990, P: 0.006); oxygen saturation (SpO2) values on admission (OR = 0.897, 95% CI = 0.811–0.993, P: 0.036); and azithromycin use (OR = 0.239, 95% CI = 0.065–0.874, P: 0.031). Conclusion The presence of malignancy; symptoms of dyspnea; high NLR; highest CRP, LDH, and creatinine levels; and low SpO2 on admission predicted mortality. On the other hand, azithromycin use was found to be protective against mortality. Knowing the causes predicting mortality will be important to treat future cases more successfully.

Prognostic value of neutrophile-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) levels for geriatric patients with COVID-19

“…A retrospective study with a total number of 233 patients admitted to emergency department for COVID-19 revealed that CRP ( p < 0.001), lactate dehydrogenase (LDH) ( p = 0.038), NLR ( p = 0.001) and PLR ( p < 0.001) levels were found as significantly higher in COVID-19 positive patients [ 13 ]. On the other hand, parallel to our findings, Bağ Soytaş et al also investigated a total number of 218 geriatric patients (≥65-year-old) with COVID-19 and they found that NLR (OR = 1.097, 95% CI: 1.012–1.188, p = 0.025) and LDH (OR = 1.002, 95% CI: 1.001–1.004, p = 0.003) values on admission as independent risk factors for the mortality [ 14 ]. Kalyon et al also showed that NLR can be a useful prognostic tool in order to determine the high risk of geriatric patients with COVID-19 in terms of mortality and they found the cut-off of NLR as 4.02 (sensitivity, 74.14%; sensitivity, 65.81%) with an area under the ROC curve as 71.7% ( p < 0.001) [ 15 ].…”

A Bibliometric Analysis of Publications on COVID-19 and Older Adults

“…14 Also, the authors of the 784 publications that were this study's focus mostly investigated the factors affecting mortality in older adults and suggested that future cases should be evaluated in terms of these factors (such as, presence of malignancy, symptoms of dyspnea, high neutrophil lymphocyte ratio and C reactive protein, lymphopenia, basic biological mechanisms of aging). [15][16][17][18] The hotspots of the future on this subject may be prospective studies involving what can be done to reduce COVID-19 mortality in older adults.…”

Does the COVID‐19 seroconversion in older adults resemble the young?

“…Many studies have reported that the mortality and morbidity of the disease are higher in older adults. [15][16][17] The positive correlation between age and Ab titer level, and when Group 2 was classified among themselves, the highest average Ab titer level of patients aged ≥80 years explains this situation more clearly.…”