Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study.

Autor: Junior AF; Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, Morumbi, São Paulo, SP, Zip code : 05652-900, Brazil. frisoli@uol.com.br.; Elderly Vulnerability Disease Research Group Unit, Cardiology Division, Federal University of São Paulo, Rua Napoleão de Barros, 715 - Térreo- Vila Clementino, São Paulo, SP, Zip code: 04024-002, Brazil. frisoli@uol.com.br., Azevedo E; Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, Morumbi, São Paulo, SP, Zip code : 05652-900, Brazil.; Osteometabolic Diseases Unit - Hospital do Servidor Público Estadual de São Paulo Av. Ibirapuera, 981. Vila Clementino, São Paulo, SP, Zip code: 04038, Brazil., Paes AT; Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, Morumbi, São Paulo, SP, Zip code : 05652-900, Brazil.; Statistics Department, Federal University of São Paulo, Rua Diogo de Faria, 1087. 4 andar, cj 408- Vila Clementino, São Paulo, SP, Zip code: 04037003, Brazil., Lima E; Elderly Vulnerability Disease Research Group Unit, Cardiology Division, Federal University of São Paulo, Rua Napoleão de Barros, 715 - Térreo- Vila Clementino, São Paulo, SP, Zip code: 04024-002, Brazil., Campos Guerra JC; Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, Morumbi, São Paulo, SP, Zip code : 05652-900, Brazil., Ingham SJMN; Elderly Vulnerability Disease Research Group Unit, Cardiology Division, Federal University of São Paulo, Rua Napoleão de Barros, 715 - Térreo- Vila Clementino, São Paulo, SP, Zip code: 04024-002, Brazil.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2022 Feb 17; Vol. 22 (1), pp. 132. Date of Electronic Publication: 2022 Feb 17.
DOI: 10.1186/s12877-022-02776-3
Abstrakt: Background: The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID-19 remain unclear.
Objective: To determine the association of chronic diseases, chest computed tomography (CT), and laboratory tests with severe respiratory failure and mortality in older adults hospitalized with COVID-19.
Method: This was a prospective cohort with 201 hospitalized older adults with COVID-19. Chronic diseases, chest CT, laboratory tests, and other data were collected within the first 48 h of hospitalization. Outcomes were progression to severe respiratory failure with the need of mechanical ventilation (SRF/MV) and death.
Results: The mean age was 72.7 ± 9.2 years, and 63.2% were men. SRF/MV occurred in 16.9% (p < 0.001), and death occurred in 8%. In the adjusted regression analyses, lung involvement over 50% [odds ratio (OR): 3.09 (1.03-9.28; 0.043)], C-reactive protein (CRP) > 80 ng/mL [OR: 2.97 (0.99-8.93; 0.052)], Vitamin D < 40 ng/mL [OR: 6.41 (1.21-33.88; 0.029)], and hemoglobin < 12 g/mL [OR: 3.32 (1.20-9.20; 0.020)] were independent predictors for SFR/MV, while chronic atrial fibrillation [OR: 26.72 (3.87-184.11; 0.001)], cancer history [OR:8.32 (1.28-53.91; 0.026)] and IL-6 > 40 pg/mL [OR:10.01 (1.66-60.13; 0.012)] were independent predictors of death.
Conclusion: In hospitalized older adults with COVID-19, tomographic pulmonary involvement > 50%, anemia, vitamin D below 40 ng/mL, and CRP above 80 mg/L were independent risk factors for progression to SRF/MV. The presence of chronic atrial fibrillation, previous cancer, IL-6 > 40 pg/mL, and anemia were independent predictors of death.
(© 2022. The Author(s).)
Databáze: MEDLINE
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