Clinical characteristics and predictors of mortality associated with COVID-19 in elderly patients from a long-term care facility
Enrico Maria Trecarichi, Maria Mazzitelli, Francesca Serapide, Maria Chiara Pelle, Bruno Tassone, Eugenio Arrighi, Graziella Perri, Paolo Fusco, Vincenzo Scaglione, Chiara Davoli, Rosaria Lionello, Valentina La Gamba, Giuseppina Marrazzo, Maria Teresa Busceti, Amerigo Giudice, Marco Ricchio, Anna Cancelliere, Elena Lio, Giada Procopio, Francesco Costanzo, Daniela Foti, Giovanni Matera, Carlo Torti, IDTM UMG COVID-19 Group, Domenico Laganà, Maria Petullà, Bernardo Bertucci, Angela Quirino, Giorgio Settimo Barreca, Aida Giancotti, Luigia Gallo, Angelo Giuseppe Lamberti, Maria Carla Liberto, Nadia Marascio, Adele Emanuela De Francesco
Abstract
Since December 2019, coronavirus disease 2019 (COVID-19) pandemic has spread from China all over the world and many COVID-19 outbreaks have been reported in long-term care facilities (LCTF). However, data on clinical characteristics and prognostic factors in such settings are scarce. We conducted a retrospective, observational cohort study to assess clinical characteristics and baseline predictors of mortality of COVID-19 patients hospitalized after an outbreak of SARS-CoV-2 infection in a LTCF. A total of 50 patients were included. Mean age was 80 years (SD, 12 years), and 24/50 (57.1%) patients were males. The overall in-hospital mortality rate was 32%. At Cox regression analysis, significant predictors of in-hospital mortality were: hypernatremia (HR 9.12), lymphocyte count < 1000 cells/µL (HR 7.45), cardiovascular diseases other than hypertension (HR 6.41), and higher levels of serum interleukin-6 (IL-6, pg/mL) (HR 1.005). Our study shows a high in-hospital mortality rate in a cohort of elderly patients with COVID-19 and hypernatremia, lymphopenia, CVD other than hypertension, and higher IL-6 serum levels were identified as independent predictors of in-hospital mortality. Given the small population size as major limitation of our study, further investigations are necessary to better understand and confirm our findings in elderly patients.