Characteristics and outcomes of older patients hospitalised for COVID-19 in the first and second wave of the pandemic in The Netherlands: the COVID-OLD study.

Autor:	Smits RAL; Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands., Trompet S; Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands., van der Linden CMJ; Department of Geriatrics, Catharina Hospital, Eindhoven, The Netherlands., van der Bol JM; Department of Geriatric Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Jansen SWM; Department of Geriatrics, Catharina Hospital, Eindhoven, The Netherlands., Polinder-Bos HA; Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands., Willems HC; Section Geriatrics, Department of Internal Medicine, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands., Barten DG; Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands., Blomaard LC; Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands., de Boer MGJ; Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands., van Deudekom FJA; Department of Internal Medicine and Geriatrics, OLVG Hospital, Amsterdam, The Netherlands., Ellerbroek JLJ; Department of Internal Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Festen J; KBO-PCOB, Etten-Leur, The Netherlands., van de Glind EMM; Department of Geriatrics, Alrijne Hospital, Leiderdorp, The Netherlands., Kampschreur LM; Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands., Karimi O; Department of Geriatric Medicine, St Jansdal Hospital, Harderwijk, The Netherlands., Kroon B; Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands., van Lanen MGJA; Department of Pulmonary Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Lucke JA; Department of Emergency Medicine, Spaarne Hospital, Haarlem, The Netherlands., Maas HAAM; Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., Mattace-Raso FUS; Section Geriatrics, Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands., van Munster BC; Department of Internal Medicine and Geriatrics, University Medical Centre Groningen, Groningen, The Netherlands., Reijerse L; Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands., Robben SHM; Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., Ruiter R; Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands., Schouten HJ; Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine, Gelre Hospitals, Apeldoorn and Zutphen, The Netherlands., Spies PE; Geriatrician and Clinical Pharmacologist, Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine Gelre Hospitals, Apeldoorn & Zutphen, The Netherlands., Wassenburg A; Department of Internal Medicine, Alrijne Hospital, Leiderdorp, The Netherlands., Wijngaarden MA; Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands., Mooijaart SP; Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2022 Mar 01; Vol. 51 (3).
DOI:	10.1093/ageing/afac048
Abstrakt:	Background: as the coronavirus disease of 2019 (COVID-19) pandemic progressed diagnostics and treatment changed. Objective: to investigate differences in characteristics, disease presentation and outcomes of older hospitalised COVID-19 patients between the first and second pandemic wave in The Netherlands. Methods: this was a multicentre retrospective cohort study in 16 hospitals in The Netherlands including patients aged ≥ 70 years, hospitalised for COVID-19 in Spring 2020 (first wave) and Autumn 2020 (second wave). Data included Charlson comorbidity index (CCI), disease severity and Clinical Frailty Scale (CFS). Main outcome was in-hospital mortality. Results: a total of 1,376 patients in the first wave (median age 78 years, 60% male) and 946 patients in the second wave (median age 79 years, 61% male) were included. There was no relevant difference in presence of comorbidity (median CCI 2) or frailty (median CFS 4). Patients in the second wave were admitted earlier in the disease course (median 6 versus 7 symptomatic days; P < 0.001). In-hospital mortality was lower in the second wave (38.1% first wave versus 27.0% second wave; P < 0.001). Mortality risk was 40% lower in the second wave compared with the first wave (95% confidence interval: 28-51%) after adjustment for differences in patient characteristics, comorbidity, symptomatic days until admission, disease severity and frailty. Conclusions: compared with older patients hospitalised in the first COVID-19 wave, patients in the second wave had lower in-hospital mortality, independent of risk factors for mortality.The better prognosis likely reflects earlier diagnosis, the effect of improvement in treatment and is relevant for future guidelines and treatment decisions. (© 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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