Clinical presentation and outcome across age categories among patients with COVID-19 admitted to a Spanish Emergency Department

Martín-Sánchez, F. Javier; del Toro, Enrique; Cardassay, Eduardo; Valls Carbó, Adrián; Cuesta, Federico; Vigara, Marta; Gil, Pedro; López Picado, Amanda López; Martínez Valero, Carmen; Miranda, Juande D.; Lopez-Ayala, Pedro; Chaparro, David; Cozar López, Gabriel; del Mar Suárez-Cadenas, María; Jerez Fernández, Pablo; Angós, Beatriz; Díaz del Arco, Cristina; Rodríguez Adrada, Esther; Montalvo Moraleda, María Teresa; Espejo Paeres, Carolina; Fernández Alonso, Cesáreo; Elvira, Carlos; Chacón, Ana; García Briñón, Miguel Ángel; Fernández Rueda, José Luis; Ortega, Luis; Fernández Pérez, Cristina; González Armengol, Juan Jorge; González del Castillo, Juan

PURPOSE: To determine the differences by age-dependent categories in the clinical profile, presentation, management, and short-term outcomes of patients with laboratory-confirmed COVID-19 admitted to a Spanish Emergency Department (ED). METHODS: Secondary analysis of COVID-19_URG-HCSC registry. We included all consecutive patients with laboratory-confirmed COVID-19 admitted to the ED of the University Hospital Clinico San Carlos (Madrid, Spain). The population was divided into six age groups. Demographic, baseline and acute clinical data, and in-hospital and 30-day outcomes were collected. RESULTS: 1379 confirmed COVID-19 cases (mean age 62 (SD 18) years old; 53.5% male) were included (18.1% < 45 years; 17.8% 45–54 years; 17.9% 55–64 years; 17.2% 65–74 years; 17.0% 75–84 years; and 11.9% ≥ 85 years). A statistically significant association was found between demographic, comorbidity, clinical, radiographic, analytical, and therapeutic variables and short-term results according to age-dependent categories. There were less COVID-specific symptoms and more atypical symptoms among older people. Age was a prognostic factor for hospital admission (aOR = 1.04; 95% CI 1.02–1.05) and in-hospital (aOR = 1.08; 95% CI 1.05–1.10) and 30-day mortality (aOR = 1.07; 95% CI 1.04–1.09), and was associated with not being admitted to intensive care (aOR = 0.95; 95% CI 0.93–0.98). CONCLUSIONS: Older age is associated with less COVID-specific symptoms and more atypical symptoms, and poor short-term outcomes. Age has independent prognostic value and may help in shared decision-making in patients with confirmed COVID-19 infection. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s41999-020-00359-2) contains supplementary material, which is available to authorized users.