Clinical Characteristics and Outcomes of 821 Older Patients With SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards.

Autor: Zerah L; Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Department of Geriatric Medicine, France.; Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France., Baudouin É; Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Department of Geriatric Medicine, France., Pépin M; APHP, Hôpital Ambroise Paré, Department of Geriatric Medicine, Boulogne, Billancourt, France.; Université de Versailles Saint-Quentin en Yvelynes, Université Paris-Saclay, INSERM, CESP, Villejuif, France., Mary M; APHP, Hôpital Paul Brousse, Department of Geriatric Medicine, Villejuif, France., Krypciak S; APHP, Hôpital Henri Mondor, Department of Geriatric Medicine, Créteil, France.; Université Paris Est Creteil, INSERM, IMRB, France., Bianco C; APHP, Hôpital Saint Antoine, Department of Geriatric Medicine, Paris, France.; Sorbonne Université, INSERM, UMRS 1135, Centre d'immunologie et de Maladies Infectieuses (CIMI), Paris, France., Roux S; APHP, Hôpital Corentin Celton, Department of Geriatric Medicine, Issy les Moulineaux, France., Gross A; APHP, Université de Paris, Hôpital Bichat, Department of Geriatric Medicine, France., Toméo C; Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Department of Geriatric Medicine, France., Lemarié N; APHP, Sorbonne Université, Hôpital Tenon, Department of Geriatric Medicine, Paris, France., Dureau A; APHP, Sorbonne Université, Hôpital Rothschild, Department of Geriatric Medicine, Paris, France., Bastiani S; APHP, Université Paris Sud, Hôpital Béclère, Department of Geriatric Medicine, Clamart, France., Ketz F; APHP, Sorbonne Université, Hôpital Charles Foix, Department of Geriatric Medicine, Ivry sur Seine, France., Boully C; APHP, Hôpital Broca, Department of Geriatric Medicine, Paris, France.; Université de Paris, Sorbonne Paris-Cité, Team, France., de Villelongue C; APHP, Université de Paris, Hôpital Bretonneau, Department of Geriatric Medicine and Palliative Care, France., Romdhani M; APHP, Université de Paris, Hôpital Bretonneau, Department of Psychogeriatric Medicine, France., Desoutter MA; APHP, Hôpital Ambroise Paré, Department of Geriatric Medicine, Boulogne, Billancourt, France.; Université de Versailles Saint-Quentin en Yvelynes, Université Paris-Saclay, INSERM, CESP, Villejuif, France., Duron E; APHP, Hôpital Paul Brousse, Department of Geriatric Medicine, Villejuif, France.; Université Paris-Saclay, INSERM 1178, CESP, Équipe MOODS. Le Kremlin-Bicêtre, France., David JP; APHP, Hôpital Henri Mondor, Department of Geriatric Medicine, Créteil, France.; Université Paris Est Creteil, INSERM, IMRB, France., Thomas C; APHP, Hôpital Saint Antoine, Department of Geriatric Medicine, Paris, France., Paillaud E; Université Paris Est Creteil, INSERM, IMRB, France.; APHP, Paris Cancer Institute CARPEM, Department of Geriatric Medicine, Hôpital Européen Georges Pompidou, France., de Malglaive P; APHP, Université de Paris, Hôpital Bichat, Department of Geriatric Medicine, France., Bouvard E; APHP, Sorbonne Université, Hôpital Tenon, Department of Geriatric Medicine, Paris, France., Lacrampe M; APHP, Sorbonne Université, Hôpital Rothschild, Department of Geriatric Medicine, Paris, France., Mercadier E; APHP, Université Paris Sud, Hôpital Béclère, Department of Geriatric Medicine, Clamart, France., Monti A; APHP, Sorbonne Université, Hôpital Charles Foix, Department of Geriatric Medicine, Ivry sur Seine, France., Hanon O; APHP, Hôpital Broca, Department of Geriatric Medicine, Paris, France.; Université de Paris, Sorbonne Paris-Cité, Team, France., Fossey-Diaz V; APHP, Université de Paris, Hôpital Bretonneau, Department of Geriatric Medicine and Palliative Care, France., Bourdonnec L; APHP, Université de Paris, Hôpital Bretonneau, Department of Psychogeriatric Medicine, France., Riou B; Sorbonne Université, UMRS INSERM 1166, Paris, France.; APHP, Hôpital La Pitié-Salpêtrière, Department of Emergency Medicine, Paris, France., Vallet H; APHP, Hôpital Saint Antoine, Department of Geriatric Medicine, Paris, France.; Sorbonne Université, INSERM, UMRS 1135, Centre d'immunologie et de Maladies Infectieuses (CIMI), Paris, France., Boddaert J; Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Department of Geriatric Medicine, France.; Sorbonne Université, INSERM, UMRS 1135, Centre d'immunologie et de Maladies Infectieuses (CIMI), Paris, France.
Jazyk: angličtina
Zdroj: The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2021 Feb 25; Vol. 76 (3), pp. e4-e12.
DOI: 10.1093/gerona/glaa210
Abstrakt: Background: There is limited information describing the characteristics and outcomes of hospitalized older patients with confirmed coronavirus disease 2019 (COVID-19).
Method: We conducted a multicentric retrospective cohort study in 13 acute COVID-19 geriatric wards, from March 13 to April 15, 2020, in Paris area. All consecutive patients aged 70 years and older, with confirmed COVID-19, were enrolled.
Results: Of the 821 patients included in the study, the mean (SD) age was 86 (7) years; 58% were female; 85% had ≥2 comorbidities; 29% lived in an institution; and the median [interquartile range] Activities of Daily Living scale (ADL) score was 4 [2-6]. The most common symptoms at COVID-19 onset were asthenia (63%), fever (55%), dyspnea (45%), dry cough (45%), and delirium (25%). The in-hospital mortality was 31% (95% confidence interval [CI] 27-33). On multivariate analysis, at COVID-19 onset, the probability of in-hospital mortality was increased with male gender (odds ratio [OR] 1.85; 95% CI 1.30-2.63), ADL score <4 (OR 1.84; 95% CI 1.25-2.70), asthenia (OR 1.59; 95% CI 1.08-2.32), quick Sequential Organ Failure Assessment score ≥2 (OR 2.63; 95% CI 1.64-4.22), and specific COVID-19 anomalies on chest computerized tomography (OR 2.60; 95% CI 1.07-6.46).
Conclusions: This study provides new information about older patients with COVID-19 who are hospitalized. A quick bedside evaluation at admission of sex, functional status, systolic arterial pressure, consciousness, respiratory rate, and asthenia can identify older patients at risk of unfavorable outcomes.
(© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze: MEDLINE
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