Hospitalization Outcomes and Mortality Predictors of SARS-Cov-2 Infection in the Elderly: A Single Center Experience from India

Abstract

Objectives: This study aimed to assess the outcome and mortality predictors of SARS-CoV-2 infection requiring hospitalization among elderly population. Methods: In this retrospective study, hospitalized elderly people with virologically confirmed SARS-CoV-2 infection were evaluated. Participants were divided into three groups of mild, moderate, and severe based on oxygenation. The primary outcome was death or discharge to home. Results: A total of 169 patients were studied (mean age: 68 years). Apart from respiratory symptoms, other reported symptoms included gastrointestinal complaints in 11% (n = 19), acute stroke in 1.1% (n = 2), delirium in 1.7% (n = 3), and anosmia or ageusia in 8.88% (n = 15). Also, 65 (38.5%) patients required oxygen support, 25 (14.7%) were admitted to the intensive care unit (ICU), 7 (4.1%) required non-invasive ventilation (Fio2 0.6 to 1.0), 14 (8.28%) were mechanically ventilated. 72 (42%) received steroid, and 100 (59%) received prophylactic heparin. Overall mortality was 12.4% (n = 21). Gender had no effect on mortality (P = 0.83). Presence of ≥ 3 risk factors, elevated neutrophil lymphocyte ratio, D-dimer, and lactate dehydrogenase, were associated with mortality (P = 0.001, P = 0.0005, P = 0.05, and P = 0.0005, respectively). Sepsis and cardiovascular events were higher among those who died. Conclusions: We observed a low mortality among the elderly treated with steroids compared to studies done in the pre-steroid period. Elevated NLR, LDH, and D-dimer were associated with mortality.

Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19

“…Neutrophil-to-lymphocyte ratio (NLR) is an indicator of the immune-inflammatory response available from routine blood tests performed at hospital admission. NLR is a good predictor of poor prognosis of COVID-19 ( Yang et al, 2020 ; Kerboua, 2021 ; Pandurangan et al, 2021 ); a non-specific transdiagnostic marker for neuropsychiatric disorders ( Mazza et al, 2018 ; Brinn and Stone, 2020 ) including delirium ( Egberts and Mattace-Raso, 2017 ; Oh et al, 2017 ; Zhao et al, 2021 ); and a prognosis marker in cardiovascular disease ( Wang et al, 2014 ), kidney disease ( Solak et al, 2013 ), and sepsis ( Huang et al, 2020 ). To our knowledge, no study has examined the link between NLR and delirium in COVID-19 hospitalized patients.…”