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Geriatr Gerontol Int · Jul 2020
Observational StudyClinical 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, and Francesco Franceschi.
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
- Geriatr Gerontol Int. 2020 Jul 1; 20 (7): 704-708.
AimThe 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.MethodsThis 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.ResultsOverall, 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, pO2 ≤90 at admission and lactate dehydrogenase >464 U/L were independent risk factors for death.ConclusionsThe 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; ••: ••-••.© 2020 Japan Geriatrics Society.
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