COVID‐19 in Older Adults: A Series of 76 Patients Aged 85 Years and Older with COVID‐19

Vrillon, Agathe; Hourregue, Claire; Azuar, Julien; Grosset, Lina; Boutelier, Ada; Tan, Sophie; Roger, Michael; Mourman, Vianney; Mouly, Stéphane; Sène, Damien; François, Véronique; Dumurgier, Julien; Paquet, Claire

BACKGROUND: Clinical presentation and risk factors of death in COVID‐19 in oldest adults have not been well characterized. OBJECTIVES: To describe clinical features and outcome of COVID‐19 in patients older than 85 years and study risk factors for mortality. DESIGN: Prospective cohort. PARTICIPANTS AND SETTING: Patients aged 85 years and older, admitted in noncritical care units at the University Hospital Lariboisière Fernand‐Widal (Paris, France) for confirmed severe acute respiratory syndrome coronavirus 2 infection were included and followed up for 21 days. MEASUREMENTS: Clinical and laboratory findings were collected. Cox survival analysis was performed to explore factors associated with death. RESULTS: From March 14 to April 11, 2020, 76 patients (median age = 90 (86–92) years; women = 55.3%) were admitted for confirmed COVID‐19. Of the patients, 64.5% presented with three or more comorbidities. Most common symptoms were asthenia (76.3%), fever (75.0%) and confusion and delirium (71.1%). An initial fall was reported in 25.0% of cases, and digestive symptoms were reported in 22.4% of cases. COVID‐19 was severe in 51.3% of cases, moderate in 32.9%, and mild in 15.8%. Complications included acute respiratory syndrome (28.9%), cardiac decompensation (14.5%), and hypotensive shock (9.0%). Fatality at 21 days was 28.9%, after a median course of disease of 13 (8–17) days. Males were overrepresented in nonsurvivors (68.2%). In survivors, median length of stay was 12 (9–19.5) days. Independent predictive factors of death were C‐reactive protein level at admission and lymphocyte count at nadir. CONCLUSION: Specific clinical features, multiorgan injury, and high case fatality rate are observed in older adults with COVID‐19. However, rapid diagnosis, appropriate care, and monitoring seem to improve prognosis.