Older Adults With Coronavirus Disease 2019: A Nationwide Study in Turkey

Abstract

Background A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) occurred in China in December 2019 and has spread globally. In this study we aimed to describe the clinical characteristics and outcomes of hospitalized older adults with coronavirus disease 2019 (COVID-19) in Turkey. Methods We retrospectively analyzed the clinical data of hospitalized patients aged ≥ 60 years with confirmed COVID-19 from March 11, 2020, to May 27, 2020 using nationwide health database. Results In this nationwide cohort, a total of 16942 hospitalized older adults with COVID-19 were enrolled, of whom 8635 (51%) were women. Mean age was 71.2 ± 8.5 years, ranging from 60 to 113 years. Mortality rate before and after curfew was statistically different (32.2% vs 17.9%; p & 0.001, respectively). Through multivariate analysis of the causes of death in older patients, we found that male gender, diabetes mellitus, heart failure, chronic kidney disease, dementia, cancer, admission to intensive care unit, computed tomography finding compatible with COVID-19 were all significantly associated with mortality in entire cohort. In addition to abovementioned risk factors, in patients aged between 60-79 years, coronary artery disease, oxygen support need, total number of drugs, and cerebrovascular disease during hospitalization, and in patients 80 years of age and older acute coronary syndrome during hospitalization were also associated with increased risk of mortality. Conclusions In addition to the results of previous studies with smaller sample size, our results confirmed the age-related relationship between specific comorbidities and COVID-19 related mortality.

The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients

“…In our study, which included data from 26 centers, the population was not restricted to severe patients but consisted of a wide spectrum of patients, mostly including mild to moderate pneumonia. This may explain the relatively low mortality rate compared to previous reports from Turkey [ 22 , 26 ] and those from other countries [ 28 , 31 , 33 ]. To the best of our knowledge, this is the first multicenter nationwide onsite dataset from Turkey for the first wave of the pandemic.…”

“…These studies were mostly conducted with a limited number of patients in a single-center setting. One large study, which used the Ministry of Health records and included 16,942 hospitalized elderly individuals only, reported mortality rates varying between 17.9-32.2% depending on the time periods with and without public restrictions [ 26 ]. However, the study provided no clinical details of the cases.…”

“…Older age is the best-known predictor of mortality, and countries with large elderly populations have been shown to have higher case-fatality rates [ 13 , 27 , [30] , [31] , [32] , [33] ]. In Turkey, the in-hospital mortality rate for patients aged 80 years and older was reported to be 32.8% [ 26 ]. Similarly, the mean ages of the non-survivors and survivors in our study were 71.3 and 50.9 years, respectively, indicating that age was an independent variable related to mortality.…”

“…Comorbidities, BMI and smoking status have been widely investigated in previous studies. In the Turkish Ministry of Health database on elderly patients, diabetes mellitus, heart failure, chronic kidney disease, coronary artery disease, dementia and cancer were found to be related to mortality [ 26 ]. Our study, which included patients who were all adults, showed that malignancy and interstitial lung disease were associated with mortality.…”

Prevalence of dementia and its impact on mortality in patients with coronavirus disease 2019: A systematic review and meta‐analysis

“…The systematic literature search flowchart is shown in Figure 1. We included a total of 10 studies in the qualitative and quantitative synthesis, comprising of 56 577 patients 17–26 . The characteristics of the included studies are shown in Table 1.…”