Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19.

Autor:	Becerra-Muñoz VM; Unidad de Gestión Clínica Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Málaga, Spain., Núñez-Gil IJ; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Eid CM; Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain., García Aguado M; Hospital Universitario Puerta de Hierro, Majadahonda, Spain., Romero R; Hospital Universitario Getafe, Madrid, Spain., Huang J; The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China., Mulet A; Hospital Clínico Universitario, Incliva, Universidad de Valencia, Valencia, Spain., Ugo F; Sant'Andrea Hospital, Vercelli, Italy., Rametta F; Sant'Andrea Hospital, Vercelli, Italy., Liebetrau C; Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany., Aparisi A; Hospital Clínico Universitario de Valladolid, Valladolid, Spain., Fernández-Rozas I; Hospital Severo Ochoa, Leganés, Spain., Viana-Llamas MC; Hospital Universitario Guadalajara, Guadalajara, Spain., Feltes G; Hospital Nuestra Señora de América, Madrid, Spain., Pepe M; Azienda ospedaliero-universitaria consorziale policlinico di Bari, Italy., Moreno-Rondón LA; Hospital General del norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador., Cerrato E; San Luigi Gonzaga University Hospital, Turin, Italy., Raposeiras-Roubín S; University Hospital Álvaro Cunqueiro, Vigo, Spain., Alfonso E; Instituto de Cardiología y Cirugía Cardiovascular, Havana, Cuba., Carrero-Fernández A; Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain., Buzón-Martín L; Hospital Universitario de Burgos, Burgos, Spain., Abumayyaleh M; First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany.; DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany., Gonzalez A; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Fernández Ortiz A; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Macaya C; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Estrada V; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Fernández-Pérez C; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Gómez-Doblas JJ; Unidad de Gestión Clínica Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Málaga, Spain.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2021 Feb 26; Vol. 50 (2), pp. 326-334.
DOI:	10.1093/ageing/afaa258
Abstrakt:	Background: the coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and mortality, particularly in older patients. Methods: post hoc analysis of the international, multicentre, 'real-world' HOPE COVID-19 registry. All patients aged ≥65 years hospitalised for COVID-19 were selected. Epidemiological, clinical, analytical and outcome data were obtained. A comparative study between two age subgroups, 65-74 and ≥75 years, was performed. The primary endpoint was all cause in-hospital mortality. Results: about, 1,520 patients aged ≥65 years (60.3% male, median age of 76 [IQR 71-83] years) were included. Comorbidities such as hypertension (69.2%), dyslipidaemia (48.6%), cardiovascular diseases (any chronic heart disease in 38.4% and cerebrovascular disease in 12.5%), and chronic lung disease (25.3%) were prevalent, and 49.6% were on ACEI/ARBs. Patients aged 75 years and older suffered more in-hospital complications (respiratory failure, heart failure, renal failure, sepsis) and a significantly higher mortality (18.4 vs. 48.2%, P < 0.001), but fewer admissions to intensive care units (11.2 vs. 4.8%). In the overall cohort, multivariable analysis demonstrated age ≥75 (OR 3.54), chronic kidney disease (OR 3.36), dementia (OR 8.06), peripheral oxygen saturation at admission <92% (OR 5.85), severe lymphopenia (<500/mm3) (OR 3.36) and qSOFA (Quick Sequential Organ Failure Assessment Score) >1 (OR 8.31) to be independent predictors of mortality. Conclusion: patients aged ≥65 years hospitalised for COVID-19 had high rates of in-hospital complications and mortality, especially among patients 75 years or older. Age ≥75 years, dementia, peripheral oxygen saturation <92%, severe lymphopenia and qSOFA scale >1 were independent predictors of mortality in this population. (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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