Clinical characteristics and prognostic factors in COVID‐19 patients aged ≥80 years
Marcello Covino, Giuseppe De Matteis, Michele Santoro, Luca Sabia, Benedetta Simeoni, Marcello Candelli, Veronica Ojetti, Francesco Franceschi
Abstract
Aim The aim of the present study was to describe the clinical presentation of patients aged ≥80 years with coronavirus disease 2019 (COVID‐19), and provide insights regarding the prognostic factors and the risk stratification in this population. Methods This was a single‐center, retrospective, observational study, carried out in a referral center for COVID‐19 in central Italy. We reviewed the clinical records of patients consecutively admitted for confirmed COVID‐19 over a 1‐month period (1–31 March 2020). We excluded asymptomatic discharged patients. We identified risk factors for death, by a uni‐ and multivariate Cox regression analysis. To improve model fitting and hazard estimation, continuous parameters where dichotomized by using Youden’s index. Results Overall, 69 patients, aged 80–98 years, met the inclusion criteria and were included in the study cohort. The median age was 84 years (82–89 years is interquartile range); 37 patients (53.6%) were men. Globally, 14 patients (20.3%) presented a mild, 30 (43.5%) a severe and 25 (36.2%) a critical COVID‐19 disease. A total of 23 (33.3%) patients had died at 30 days’ follow up. Multivariate Cox regression analysis showed that severe dementia, pO 2 ≤90 at admission and lactate dehydrogenase >464 U/L were independent risk factors for death. Conclusions The present data suggest that risk of death could be not age dependent in patients aged ≥80 years, whereas severe dementia emerged is a relevant risk factor in this population. Severe COVID‐19, as expressed by elevated lactate dehydrogenase and low oxygen saturation at emergency department admission, is associated with a rapid progression to death in these patients. Geriatr Gerontol Int 2020; ••: ••–•• .