Confirmed SARS-CoV-2 infection and mortality: Associated factors in hospitalized people 75 and older
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Geriatrics Unit, Hospital Universitario San Ignacio, Bogotá D.C., COLOMBIA
Institute of Aging, School of Medicine, Pontificia Universidad Javeriana, Bogotá D.C., COLOMBIA
Geriatrics Service, Clínica del Country, Bogotá D.C., COLOMBIA
Department of Internal Medicine and Geriatrics, Hospital Cardiovascular de Cundinamarca, San Mateo, Soacha, COLOMBIA
Online publication date: 2023-03-07
Publication date: 2023-05-01
Electron J Gen Med 2023;20(3):em479
COVID-19 infection in the elderly posed challenges in health systems and clinical care by health personnel.

To describe the factors associated with mortality in persons aged 75 and older with COVID-19 in a high complexity hospital in Bogotá, Colombia.

Observational, analytical and retrospective study, including 509 patients aged 75 and older hospitalized with COVID-19.

40.47% died during hospital stay. It was found that a shorter time of symptom onset at admission, a respiratory rate greater than 20 breaths per minute, having thrombocytopenia, elevated lactate dehydrogenase and elevated D-dimer were associated with higher in-hospital mortality.

There is an association between mortality and the presence of dyspnea, fever and delirium. Paraclinical results with lactate dehydrogenase >350 (U/L), the presence of elevated D-dimer greater than 1,000 μg/L, as well as a Pa02/Fi02 ratio with a median of less than 90, were associated with higher mortality.

Guan W-J, Ni Z-Y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. https://doi.org/10.1056/NEJMoa... PMid:32109013 PMCid:PMC7092819.
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33. https://doi.org/10.1056/NEJMoa... PMid:31978945 PMCid:PMC7092803.
Cuestas ML, Minassian ML. COVID-19: Impact of a pandemic. Rev Argent Microbiol. 2020;52(3):167-8. https://doi.org/10.1016/j.ram.... PMid:33032744 PMCid:PMC7535794.
JHCRC. COVID-19 map. Johns Hopkins Coronavirus Resource Center. Available at: https://coronavirus.jhu.edu/ma... (Accessed: 28 October 2022).
Pérez-Zepeda MU, Campos-Fajardo S, Cano-Gutierrez C. COVID-19 related mortality in older adults: analysis of the first wave in Colombia and Mexico. Rev Panam Salud Publica. 2021;45:e109. https://doi.org/10.26633/RPSP.... PMid:34475888 PMCid:PMC8369102.
Saavedra Trujillo CH. Colombian consensus on care, diagnosis and management of SARS-COV-2/COVID 19 infection in health care establishments. Recommendations based on expert consensus and informed by evidence. Infect Asoc Colomb Infectology. 2021;24(3):1-153. https://doi.org/10.22354/in.v2....
Almeida-Espinosa A, Sarmiento-Ardila JA. COVID-19: implications of SARS-CoV-2 in Colombia. Gac Med Mex. 2020;156(4):334-8. https://doi.org/10.24875/GMM.M... PMid:32831328.
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi.org/10.1016/S0140-... PMid:31986264.
Domingues R, Lippi A, Setz C, Outeiro TF, Krisko A. SARS-CoV-2, immunosenescence and inflammaging: partners in the COVID-19 crime. Aging (Albany NY). 2020;12(18):18778-89. https://doi.org/10.18632/aging... PMid:32991323 PMCid:PMC7585069.
Bonanad C, García-Blas S, Tarazona-Santabalbina FJ, et al. [Coronavirus: The geriatric emergency of 2020. Joint document of the Section on Geriatric Cardiology of the Spanish Society of Cardiology and the Spanish Society of Geriatrics and Gerontology]. Rev Esp Cardiol. 2020;73(7):569-76. https://doi.org/10.1016/j.rece... PMCid:PMC7129713.
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi.org/10.1016/S0140-... PMid:32171076.
Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81. https://doi.org/10.1016/S2213-... PMid:32105632.
Chang TI, Park H, Kim DW, et al. Polypharmacy, hospitalization, and mortality risk: A nationwide cohort study. Sci Rep. 2020;10(1):18964. https://doi.org/10.1038/s41598... PMid:33144598 PMCid:PMC7609640.
Ariza-Galindo CJ, Venegas-Sanabria LC, Chavarro-Carvajal DA, Muñoz-Velandia OM. Lymphopenia and risk of nosocomial infections in the elderly in a health care institution in Bogotá, Colombia. A case-control study. Infect Asoc Colomb Infectology. 2020;24(3):155-61. https://doi.org/10.22354/in.v2....
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. https://doi.org/10.1001/jama.2... PMid:32091533.
Águila-Gordo D, Martínez-Del Río J, Mazoteras-Muñoz V, Negreira-Caamaño M, Nieto-Sandoval Martín de la Sierra P, Piqueras-Flores J. Mortality and associated prognostic factors in elderly and very elderly hospitalized patients with respiratory disease COVID-19. Rev Esp Geriatr Gerontol. 2021;56(5):259-67. https://doi.org/10.1016/j.regg... PMid:33610380 PMCid:PMC7656995.
Azwar MK, Setiati S, Rizka A, Fitriana I, Saldi SRF, Safitri ED. Clinical profile of elderly patients with COVID-19 hospitalised in Indonesia’s National General Hospital. Acta Med Indones. 2020;52(3):199-205.
Norman DC. Fever in the elderly. Clin Infect Dis. 2000;31(1):148-51. https://doi.org/10.1086/313896 PMid:10913413.
Shao S-C, Lai C-C, Chen Y-H, Chen Y-C, Hung M-J, Liao S-C. Prevalence, incidence and mortality of delirium in patients with COVID-19: A systematic review and meta-analysis. Age Ageing. 2021;50(5):1445-53. https://doi.org/10.1093/ageing... PMid:33984129 PMCid:PMC8247209.
Garcez FB, Aliberti MJR, Poco PCE, et al. Delirium and adverse outcomes in hospitalized patients with COVID-19. J Am Geriatr Soc. 2020;68(11):2440-6. https://doi.org/10.1111/jgs.16... PMid:32835425 PMCid:PMC7460960.
Witlox J, Eurelings LSM, de Jonghe JFM, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: A meta-analysis. JAMA. 2010;304(4):443-51. https://doi.org/10.1001/jama.2... PMid:20664045.
Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with coronavirus disease 2019 (COVID-19) infection: A systematic review and meta-analysis of observational studies. Aging Male. 2020;23(5):1416-24. https://doi.org/10.1080/136855... PMid:32508193.
Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: A systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis. 2021; 21(1):855. https://doi.org/10.1186/s12879... PMid:34418980 PMCid:PMC8380115.
Berenguer J, Ryan P, Rodríguez-Baño J, et al. Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain. Clin Microbiol Infect. 2020;26(11):1525-36. https://doi.org/10.1016/j.cmi.... PMid:32758659 PMCid:PMC7399713.
Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. https://doi.org/10.1016/j.jaut... PMid:32113704 PMCid:PMC7127067.
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7. https://doi.org/10.1111/jth.14... PMid:32073213 PMCid:PMC7166509.
Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438-40. https://doi.org/10.1016/S2352-... PMid:32407672.
Acevedo-Peña J, Yomayusa-González N, Cantor-Cruz F, et al. Colombian consensus for the prevention, diagnosis and treatment of thrombotic conditions in adults with COVID-19: Applying the evidence to decision (EtD) grade framework. Rev Colomb Cardiol. 2020;27(5):446-60.
Piera Carbonell A, Frías Vargas M, García Vallejo O, et al. COVID-19 and thromboprophylaxis: Recommendations for our clinical practice in primary care. Semergen. 2020;46(7):479-86. https://doi.org/10.1016/j.seme... PMid:33046353 PMCid:PMC7500906.
Schulman S, Sholzberg M, Spyropoulos AC, et al. ISTH guidelines for antithrombotic treatment in COVID-19. J Thromb Haemost. 2022;20(10):2214-25. https://doi.org/10.1111/jth.15... PMid:35906716 PMCid:PMC9349907.
Henry BM, Aggarwal G, Wong J, et al. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am J Emerg Med. 2020;38(9):1722-6. https://doi.org/10.1016/j.ajem... PMid:32738466 PMCid:PMC7251362.
Bartziokas K, Kostikas K. Lactate dehydrogenase, COVID-19 and mortality. Med Clin (Barc). 2021;156(1):37. https://doi.org/10.1016/j.medc... PMCid:PMC7518167.
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