Differences in characteristics and outcomes of older patients hospitalized for COVID-19 after introduction of vaccination.

Author:

Smits Rosalinde1ORCID,Raaij Bas F.M. van1,Trompet Stella1,Linden Caroline M.J. van der2,Bol Jessica M. van der3,Jansen Steffy W.M.2,Polinder-Bos Harmke A.4,Willems Hanna C.5,de Glind Esther M.M. van6,Minnema Julia4,Tap Lisanne4,Mooijaart Simon P.1

Affiliation:

1. LUMC: Leids Universitair Medisch Centrum

2. Catharina Hospital: Catharina Ziekenhuis

3. Reinier de Graaf Hospital: Reinier de Graaf Gasthuis

4. Erasmus Medical Centre: Erasmus MC

5. Amsterdam UMC Location AMC: Amsterdam UMC Locatie AMC

6. Alrijne Hospital Location Leiderdorp: Alrijne Ziekenhuis Locatie Leiderdorp

Abstract

Abstract

Purpose: The aim of the present study was to investigate characteristics and outcomes in vaccinated and unvaccinated older patients hospitalized for COVID-19 infection. Methods: A retrospective multicentre cohort study among patients aged ≥70 years hospitalized for COVID-19 infection. Results: 263 vaccinated and 82 unvaccinated patients were included. Vaccinated patients were older (median age 79 vs. 76 years; p<0.001), had more comorbidities (median Charlson Comorbidity Index (CCI) 2 vs. 1; p0.016) and were frailer (Clinical Frailty Scale (CFS) ≥4 68% vs. 49%; p0.015). Vaccinated patients were admitted earlier after symptom onset (median 5 days vs. 7 days) but were equally ill at time of hospital admission. After correction for frailty, comorbidity and disease severity, risk of in-hospital mortality was three times lower for vaccinated patients (HR 0.30 95% CI 0.16-0.56; p<0.001) compared to unvaccinated patients. Conclusion: Compared to older unvaccinated patients hospitalized for COVID-19, vaccinated patients were frailer, had more comorbidities but, independent of these factors, a three times lower risk for in-hospital mortality. These findings may trigger pro-active geriatric advance care planning, aimed toward early rehabilitation.

Publisher

Research Square Platform LLC

Reference17 articles.

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2. Pastorino R et al (2022) Change in age distribution of COVID-19 deaths with the introduction of COVID-19 vaccination. Environ Res, 204(Pt C): p. 112342

3. RIVM. Figues on the COVID-19 vaccination programme (2024) 17 January 2024; https://www.rivm.nl/en/coronavirus-covid-19/current/vaccination-figures

4. Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study;Blomaard LC;Age Ageing,2021

5. team, t.N. Genomic epidemiology of SARS-CoV-2 with subsampling focused on Europe since pandemic start. (2022) ; https://nextstrain.org/ncov/open/europe/all-time

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