Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19
Víctor Manuel Becerra‐Muñoz, Iván J. Núñez‐Gil, Charbel Maroun‐Eid, Marcos Garcı́a Aguado, Rodolfo Romero, Jia Huang, Alba Mulet, Fabrizio Ugo, Francesco Rametta, Christoph Liebetrau, Álvaro Aparisi, Inmaculada Fernández‐Rozas, María C. Viana‐Llamas, Gisela Feltes, Martino Pepe, Luis Moreno-Rondón, Enrico Cerrato, Sergio Raposeiras‐Roubín, Emilio Alfonso, Ana Carrero-Fernández, Luís Buzón, Mohammad Abumayyaleh, Adelina González, Antonio Fernández‐Ortíz, Carlos Macaya, Vicente Estrada, Cristina Fernández, Juan José Gómez‐Doblas
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.