COVID-19 in older adults: What are the differences with younger patients?

Aim The present study aimed both to gain knowledge on the distinctive clinical characteristics of older adults with coronavirus disease 2019 (COVID-19), in comparison with those of younger patients, and to identify risk factors for mortality. Methods A retrospective observational study was carried o...

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Bibliographic Details
Authors: Gómez-Belda AB, Fernández-Garcés M, Mateo-Sanchis E, Madrazo M, Carmona M, Piles-Roger L, Artero A
Format: article
Status:Published version
Publication Date:2021
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p8409
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/8409
Access Level:Open access
Keyword:clinical characteristics
coronavirus
COVID-19
mortality
older adults
Description
Summary:Aim The present study aimed both to gain knowledge on the distinctive clinical characteristics of older adults with coronavirus disease 2019 (COVID-19), in comparison with those of younger patients, and to identify risk factors for mortality. Methods A retrospective observational study was carried out of patients consecutively admitted to Doctor Peset University Hospital, Valencia (Spain) for COVID-19 from 11 March to 28 April 2020. Every case was diagnosed by reverse transcription polymerase chain reaction or by serology test to detect antibodies. Demographic details, clinical characteristics, laboratory findings on admission and complications of each case were collected from electronic medical records. Results The dataset comprised 340 patients. Of them, 152 (44.6%) were aged >70 years. Comorbidities were more common in the older groups. Confusion was more common in older adults, whereas typical symptoms of COVID-19, such as fever, cough and myalgia, were less common. Oxygen saturation <= 93% on room air, neutrophilia, D-dimer >0.5 mu g/mL, creatinine >1.5 mg/dL, lactate dehydrogenase >= 250 U/L and elevation of creatine kinase were higher in the older adult groups. Complications during hospitalization, such as acute respiratory distress syndrome (53.3% vs 33.2%, P < 0.001), acute kidney injury (11.8% vs 5.3%; P = 0.030) and mortality (28.9% vs 6.5%; P < 0.001) were more common in patients aged >70 years. Oxygen saturation <= 93% on room air on admission was a predictor of mortality (odds ratio 11.65, 95% confidence interval 3.26-41.66, P < 0.001) in patients aged >70 years. Conclusions Older adults with COVID-19 have more atypical presentation, more complications and higher mortality. Oxygen saturation <= 93% on room air on admission is a predictive factor of death. Geriatr Gerontol Int 2020; center dot center dot: center dot center dot-center dot center dot.