Clinical profile and predictors of in-hospital mortality among older patients admitted for COVID-19

Becerra-Muñoz, Víctor Manuel; Núñez-Gil, Iván J; Eid, Charbel Maroun; Aguado, Marcos García; Romero, Rodolfo; Huang, Jia; Mulet, Alba; Ugo, Fabrizio; Rametta, Francesco; Liebetrau, Christoph; Aparisi, Alvaro; Fernández-Rozas, Inmaculada; Viana-Llamas, María C; Feltes, Gisela; Pepe, Martino; Moreno-Rondón, Luis A; Cerrato, Enrico; Raposeiras-Roubín, Sergio; Alfonso, Emilio; Carrero-Fernández, Ana; Buzón-Martín, Luis; Abumayyaleh, Mohammad; Gonzalez, Adelina; Ortiz, Antonio Fernández; Macaya, Carlos; Estrada, Vicente; Fernández-Pérez, Cristina; Gómez-Doblas, Juan José

BACKGROUND: The coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and mortality, particularly in older patients. METHODS: Post-hoc analysis of the international, multicentre, “real-world” HOPE COVID-19 registry. All patients aged ≥65 years hospitalised for COVID-19 were selected. Epidemiological, clinical, analytical and outcome data were obtained. A comparative study between two age subgroups, 65–74 and ≥75 years, was performed. The primary endpoint was all cause in-hospital mortality. RESULTS: 1,520 patients aged ≥65 years (60.3% male, median age of 76 [IQR 71–83] years) were included. Comorbidities such as hypertension (69.2%), dyslipidemia (48.6%), cardiovascular diseases (any chronic heart disease in 38.4% and cerebrovascular disease in 12.5%), and chronic lung disease (25.3%) were prevalent, and 49.6% were on ACEI/ARBs. Patients aged 75 years and older suffered more in-hospital complications (respiratory failure, heart failure, renal failure, sepsis) and a significantly higher mortality (18.4 vs. 48.2%, P < 0.001), but fewer admissions to intensive care units (11.2 vs. 4.8%). In the overall cohort, multivariable analysis demonstrated age ≥75 (OR 3.54), chronic kidney disease (OR 3.36), dementia (OR 8,06), peripheral oxygen saturation at admission <92% (OR 5.85), severe lymphopenia (<500/mm(3)) (OR 3.36) and qSOFA (Quick Sequential Organ Failure Assessment Score) >1 (OR 8.31) to be independent predictors of mortality. CONCLUSION: Patients aged ≥65 years hospitalised for COVID-19 had high rates of in-hospital complications and mortality, especially among patients 75 years or older. Age ≥75 years, dementia, peripheral oxygen saturation <92%, severe lymphopenia and qSOFA scale >1 were independent predictors of mortality in this population.