Clinical Interventions in Aging (Jul 2023)

Variables Associated with 30-Day Mortality in Very Elderly COVID-19 Patients

  • Xing Y,
  • Sun Y,
  • Tang M,
  • Huang W,
  • Luo J,
  • Ma Q

Journal volume & issue
Vol. Volume 18
pp. 1155 – 1162

Abstract

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Yunli Xing, Ying Sun, Mei Tang, Wei Huang, Jia Luo, Qing Ma Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Qing Ma, Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, People’s Republic of China, Tel +86 13801019331, Fax +86 10 6313 8040, Email [email protected]: Advanced age increases the risk for severe COVID-19. However, the risk factors for mortality from COVID-19 in very elderly patients (≥ 80-years-old) are unknown.Objective: Investigate the relationship of mortality with the clinical characteristics of very elderly COVID-19 patients.Materials and Methods: Very elderly patients who were hospitalized with COVID-19 from December 3, 2022 to January 1, 2023 were retrospectively examined. Sociodemographic and clinical variables were recorded and survival was recorded after 30 days.Results: We examined 181 patients (median age: 90.84 years; 114 older than 90 years). The median Barthel index was 30.69, and 55.8% of patients had severe or critical COVID-19 pneumonia. Forty-two patients (33.2%) received a high-flow nasal cannula or non-invasive ventilation, and only 4.4% received mechanical ventilation. The overall mortality was 35.9%, and there was no significant difference in mortality for the 80 to 90-year-old group and the over 90-year-old group (37.7% vs 32.8%, P=0.508). A multivariate analysis showed that the Barthel index (OR, 0.975; 95% CI, 0.962– 0.989), serum creatinine (SCr) level (OR, 1.003; 95% CI, 1.000– 1.006), white blood cell (WBC) count (OR, 1.160; 95% CI, 1.056– 1.276), D-dimer level (OR, 1.060; 95% CI, 1.009– 1.113), and corticosteroid use (OR, 0.268; 95% CI, 0.124– 0.582) were significantly and independently related to 30-day mortality. A binary classification model based on the multivariate analysis had good predictive value (area under the curve, 0.794).Conclusion: Very elderly COVID-19 patients have a high risk for mortality. The Barthel index, SCr, WBC count, D-dimer level, and corticosteroid use were independently associated with mortality.Keywords: COVID-19, over-80-year-old, characteristic, mortality

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