The Impact of the Third Wave of the COVID-19 Pandemic on the Elderly and Very Elderly Population in a Tertiary Care Hospital in Portugal

Abstract

Background: COVID-19 poses a significantly more serious threat to adults aged 65 and above, with a higher mortality rate. This study aims to describe the outcome of COVID-19 patients in the elderly and very elderly population admitted to a tertiary care Portuguese hospital. The authors defined the elderly population (65 to 79 years) and the very elderly population (≥ 80 years).Methods: We conducted a retrospective observational single center study in the internal medicine ward of a tertiary hospital from November 1, 2020 to January 31, 2021. All COVID-19 patients aged over 65 years were enrolled.Results: Of the 824 patients with SARS-CoV-2 infection, 586 (71%) were aged above 65 years. Of them, 61.7% were very elderly and 32.9% were elderly. The hospital recorded 53 (27.5%) deaths in the elderly group and 182 (46.3%) in the over-80 group. In the elderly population, only 32 patients had critical illness compared to the 79 in the very elderly group. In addition to respiratory complications, acute kidney failure and liver dysfunction were noted. In both groups, mortality was higher when there was acute kidney injury (AKI). With respect to treatment, dexamethasone and azithromycin did not show a statistically significant difference between the groups. The need for oxygen therapy over 4L/min, high-flow therapy, and mechanical invasive ventilation was related to higher mortality in both groups. Conclusion:The very elderly group had a higher number of deaths compared to the elderly group due to multiple comorbidities. Respiratory failure was the most frequently occurring complication. Surprisingly, dexamethasone and azithromycin therapy did not show a statistically significant effect in both age groups despite their current widespread usage in COVID-19 treatment worldwide.

Liver injury in COVID-19: Clinical features, potential mechanisms, risk factors and clinical treatments

“…Although only a small proportion (1.7%) of patients without prior liver disease also died from liver-related causes, severe liver impairment and acute liver failure are rare but important complications of COVID-19[ 63 ]. Liver dysfunction is associated with poor prognosis in elderly patients with higher mortality due to liver cell damage[ 64 ].…”

Influence of SARS-CoV-2 Status and Aging on the Nasal and Fecal Immunological Profiles of Elderly Individuals Living in Nursing Homes

“…During this 3-year period, this infectious disease was associated (and still is) with high mortality and morbidity rates worldwide, although the impact of the disease has been particularly strong among the elderly (≥65 years) [ 1 ]. This population was associated with the highest risks of hospitalization, severity, and mortality [ 2 , 3 , 4 ]. The high susceptibility of the elderly seems to be due to the confluence of most, if not all, COVID-19-related risk factors, including high rates of hypertension, cardiovascular disease, chronic respiratory diseases, diabetes, chronic kidney diseases, and malnutrition, among other comorbidities [ 5 , 6 , 7 ].…”

Administration of Ligilactobacillus salivarius CECT 30632 to elderly during the COVID-19 pandemic: Nasal and fecal metataxonomic analysis and fatty acid profiling

“…Elderly was the most affected population during the first COVID-19 waves. In fact, the risk of a severe course, functional and nutritional complications, and mortality from COVID-19 was much higher among older people (≥ 65 years) than among younger people (Boccardi et al, 2020;Liu et al, 2020;Silva et al, 2020;Pizarro-Pennarolli et al, 2021;Palavras et al, 2022). Such a strong impact on elderly has been explained on the basis of an accumulation of risk factors, including multiple key comorbidities, such as, among others, weakened immune systems, hypertension, diabetes, cardiovascular disease, chronic kidney disease, and chronic respiratory disease (Araújo et al, 2021).…”