Clinical Characteristics and Outcomes of 821 Older Patients With SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards

Author:

Zerah Lorène12,Baudouin Édouard1,Pépin Marion34,Mary Morgane5,Krypciak Sébastien67,Bianco Céline89,Roux Swasti10,Gross Ariane11,Toméo Charlotte1,Lemarié Nadège12,Dureau Antoine13,Bastiani Sophie14,Ketz Flora15,Boully Clémence1617,de Villelongue Cédric18,Romdhani Mouna19,Desoutter Marie-Astrid34,Duron Emmanuelle520ORCID,David Jean-Philippe67,Thomas Caroline8,Paillaud Elena721,de Malglaive Pauline11,Bouvard Eric12,Lacrampe Mathilde13,Mercadier Elise14,Monti Alexandra15,Hanon Olivier1617,Fossey-Diaz Virginie18,Bourdonnec Lauriane19,Riou Bruno2223,Vallet Hélène89ORCID,Boddaert Jacques19

Affiliation:

1. Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Department of Geriatric Medicine, France

2. Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris, France

3. APHP, Hôpital Ambroise Paré, Department of Geriatric Medicine, Boulogne, Billancourt, France

4. Université de Versailles Saint-Quentin en Yvelynes, Université Paris-Saclay, INSERM, CESP, Villejuif, France

5. APHP, Hôpital Paul Brousse, Department of Geriatric Medicine, Villejuif, France

6. APHP, Hôpital Henri Mondor, Department of Geriatric Medicine, Créteil, France

7. Université Paris Est Creteil, INSERM, IMRB, France

8. APHP, Hôpital Saint Antoine, Department of Geriatric Medicine, Paris, France

9. Sorbonne Université, INSERM, UMRS 1135, Centre d’immunologie et de Maladies Infectieuses (CIMI), Paris, France

10. APHP, Hôpital Corentin Celton, Department of Geriatric Medicine, Issy les Moulineaux, France

11. APHP, Université de Paris, Hôpital Bichat, Department of Geriatric Medicine, France

12. APHP, Sorbonne Université, Hôpital Tenon, Department of Geriatric Medicine, Paris, France

13. APHP, Sorbonne Université, Hôpital Rothschild, Department of Geriatric Medicine, Paris, France

14. APHP, Université Paris Sud, Hôpital Béclère, Department of Geriatric Medicine, Clamart, France

15. APHP, Sorbonne Université, Hôpital Charles Foix, Department of Geriatric Medicine, Ivry sur Seine, France

16. APHP, Hôpital Broca, Department of Geriatric Medicine, Paris, France

17. Université de Paris, Sorbonne Paris-Cité, Team, France

18. APHP, Université de Paris, Hôpital Bretonneau, Department of Geriatric Medicine and Palliative Care, France

19. APHP, Université de Paris, Hôpital Bretonneau, Department of Psychogeriatric Medicine, France

20. Université Paris-Saclay, INSERM 1178, CESP, Équipe MOODS. Le Kremlin-Bicêtre, France

21. APHP, Paris Cancer Institute CARPEM, Department of Geriatric Medicine, Hôpital Européen Georges Pompidou, France

22. Sorbonne Université, UMRS INSERM 1166, Paris, France

23. APHP, Hôpital La Pitié-Salpêtrière, Department of Emergency Medicine, Paris, France

Abstract

Abstract Background There is limited information describing the characteristics and outcomes of hospitalized older patients with confirmed coronavirus disease 2019 (COVID-19). Method We conducted a multicentric retrospective cohort study in 13 acute COVID-19 geriatric wards, from March 13 to April 15, 2020, in Paris area. All consecutive patients aged 70 years and older, with confirmed COVID-19, were enrolled. Results Of the 821 patients included in the study, the mean (SD) age was 86 (7) years; 58% were female; 85% had ≥2 comorbidities; 29% lived in an institution; and the median [interquartile range] Activities of Daily Living scale (ADL) score was 4 [2–6]. The most common symptoms at COVID-19 onset were asthenia (63%), fever (55%), dyspnea (45%), dry cough (45%), and delirium (25%). The in-hospital mortality was 31% (95% confidence interval [CI] 27–33). On multivariate analysis, at COVID-19 onset, the probability of in-hospital mortality was increased with male gender (odds ratio [OR] 1.85; 95% CI 1.30–2.63), ADL score <4 (OR 1.84; 95% CI 1.25–2.70), asthenia (OR 1.59; 95% CI 1.08–2.32), quick Sequential Organ Failure Assessment score ≥2 (OR 2.63; 95% CI 1.64–4.22), and specific COVID-19 anomalies on chest computerized tomography (OR 2.60; 95% CI 1.07–6.46). Conclusions This study provides new information about older patients with COVID-19 who are hospitalized. A quick bedside evaluation at admission of sex, functional status, systolic arterial pressure, consciousness, respiratory rate, and asthenia can identify older patients at risk of unfavorable outcomes.

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Ageing

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