Clinical characteristics and predictors of mortality associated with COVID-19 in elderly patients from a long-term care facility

Trecarichi, Enrico Maria; Mazzitelli, Maria; Serapide, Francesca; Pelle, Maria Chiara; Tassone, Bruno; Arrighi, Eugenio; Perri, Graziella; Fusco, Paolo; Scaglione, Vincenzo; Davoli, Chiara; Lionello, Rosaria; La Gamba, Valentina; Marrazzo, Giuseppina; Busceti, Maria Teresa; Giudice, Amerigo; Ricchio, Marco; Cancelliere, Anna; Lio, Elena; Procopio, Giada; Costanzo, Francesco Saverio; Foti, Daniela Patrizia; Matera, Giovanni; Torti, Carlo

Since December 2019, coronavirus disease 2019 (COVID-19) pandemic has spread from China all over the world and many COVID-19 outbreaks have been reported in long-term care facilities (LCTF). However, data on clinical characteristics and prognostic factors in such settings are scarce. We conducted a retrospective, observational cohort study to assess clinical characteristics and baseline predictors of mortality of COVID-19 patients hospitalized after an outbreak of SARS-CoV-2 infection in a LTCF. A total of 50 patients were included. Mean age was 80 years (SD, 12 years), and 24/50 (57.1%) patients were males. The overall in-hospital mortality rate was 32%. At Cox regression analysis, significant predictors of in-hospital mortality were: hypernatremia (HR 9.12), lymphocyte count < 1000 cells/µL (HR 7.45), cardiovascular diseases other than hypertension (HR 6.41), and higher levels of serum interleukin-6 (IL-6, pg/mL) (HR 1.005). Our study shows a high in-hospital mortality rate in a cohort of elderly patients with COVID-19 and hypernatremia, lymphopenia, CVD other than hypertension, and higher IL-6 serum levels were identified as independent predictors of in-hospital mortality. Given the small population size as major limitation of our study, further investigations are necessary to better understand and confirm our findings in elderly patients.