Víctor Manuel Becerra-Muñoz1, Iván J Núñez-Gil2, Charbel Maroun Eid3, Marcos García Aguado4, Rodolfo Romero5, Jia Huang6, Alba Mulet7, Fabrizio Ugo8, Francesco Rametta8, Christoph Liebetrau9, Alvaro Aparisi10, Inmaculada Fernández-Rozas11, María C Viana-Llamas12, Gisela Feltes13, Martino Pepe14, Luis A Moreno-Rondón15, Enrico Cerrato16, Sergio Raposeiras-Roubín17, Emilio Alfonso18, Ana Carrero-Fernández19, Luis Buzón-Martín20, Mohammad Abumayyaleh21,22, Adelina Gonzalez23, Antonio Fernández Ortiz2, Carlos Macaya2, Vicente Estrada2, Cristina Fernández-Pérez2, Juan José Gómez-Doblas1. 1. 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. 2. 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. 3. Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain. 4. Hospital Universitario Puerta de Hierro, Majadahonda, Spain. 5. Hospital Universitario Getafe, Madrid, Spain. 6. The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China. 7. Hospital Clínico Universitario, Incliva, Universidad de Valencia, Valencia, Spain. 8. Sant'Andrea Hospital, Vercelli, Italy. 9. Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany. 10. Hospital Clínico Universitario de Valladolid, Valladolid, Spain. 11. Hospital Severo Ochoa, Leganés, Spain. 12. Hospital Universitario Guadalajara, Guadalajara, Spain. 13. Hospital Nuestra Señora de América, Madrid, Spain. 14. Azienda ospedaliero-universitaria consorziale policlinico di Bari, Italy. 15. Hospital General del norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador. 16. San Luigi Gonzaga University Hospital, Turin, Italy. 17. University Hospital Álvaro Cunqueiro, Vigo, Spain. 18. Instituto de Cardiología y Cirugía Cardiovascular, Havana, Cuba. 19. Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain. 20. Hospital Universitario de Burgos, Burgos, Spain. 21. First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany. 22. DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany. 23. Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.
Abstract
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.
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.
Authors: Tony Zitek; Kathleen Jodoin; Tarang Kheradia; Ryan Napolillo; Michael T Dalley; Faith Quenzer; David A Farcy Journal: Am J Emerg Med Date: 2021-11-02 Impact factor: 4.093
Authors: Erik Lagolio; Jacopo Demurtas; Thomas Benzing; Maria Cristina Polidori; Roberto Buzzetti; Giorgio Cortassa; Stefania Bottone; Laura Spadafora; Cristina Cocino; Lee Smith Journal: Intern Emerg Med Date: 2021-07-28 Impact factor: 5.472