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. 2021 Jun;12(3):601-607.
doi: 10.1007/s41999-020-00432-w. Epub 2020 Nov 27.

COVID-19 mortality risk factors in older people in a long-term care center

Eva Heras  1 , Pablo Garibaldi  2 , Maite Boix  2 , Oliver Valero  3 , Jorge Castillo  2 , Yurisan Curbelo  2 , Elso Gonzalez  2 , Obilagilio Mendoza  2 , Maria Anglada  2 , Joan Carles Miralles  2 , Petra Llull  2 , Ricard Llovera  2 , Josep M Piqué  2
Affiliations

COVID-19 mortality risk factors in older people in a long-term care center

Eva Heras et al. Eur Geriatr Med. 2021 Jun.

Abstract

Purpose: Despite high rates of COVID-19 infection and increased related mortality have been reported among older adults admitted in long-term care facilities, a limited amount of information is available about the natural course of this pandemic and prognostic factors in such population. In the current study, we aimed to investigate the epidemiologic, demographics, clinical, or therapeutic factors that may predict the prognosis in a cohort of COVID-19 infected institutionalized older in a nursing home.

Methods: We conducted a retrospective analysis of all COVID-19 confirmed institutionalized older in a nursing home from March 15 to June 5, 2020. Epidemiological, demographic, and frailty status before infection, and clinical, laboratory, treatment, and outcome data during infection were collected. We used bivariate analysis and multivariate logistic regression to identify risk factors for mortality.

Results: The analysis comprised all 100 COVID-19 confirmed cases during the study period. The median age was 85 years; 62% were female. The case fatality rate was 20%. In the bivariate analysis, male gender, fever, respiratory symptoms, severe cognitive decline, a low Barthel index, and lymphocytopenia were significantly associated with mortality. Patients treated with hydroxychloroquine plus azithromycin were related to a higher chance of survival than those without pharmacological treatment. Multivariate logistic regression analysis identified male gender, low Barthel index, no pharmacological treatment, and lymphocytopenia as independent risk factors associated with mortality.

Conclusions: Male gender, low Barthel index, and lymphocytopenia are independent risk factors for COVID-19 mortality in institutionalized older patients in long-term care nursing homes. Treatment with hydroxychloroquine and azithromycin was associated with lower mortality in these patients.

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Conflict of interest statement

We declare no competing interests.

Figures

Fig. 1
Fig. 1
Functional capacity and percentage of COVID-19 patients cured
Fig. 2
Fig. 2
Type of treatment and percentage of COVID-19 patients cured. H + A hydroxychloroquine and azithromycin. H hydroxychloroquine. No treatment includes Others: Beta-lactam or Quinolone antibiotics
Fig. 3
Fig. 3
Prognostic COVID-19 mortality score-ROC curve for model
See this image and copyright information in PMC

References

    1. Zhou F, Yu T, Du R, Fan G, Liu Y, Xiang J, et al. Clinical course and risk factors for mortality of adult in-patients with COVID-19 in Wuhan, China: a retrospective study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
    1. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323:2052–2059. doi: 10.1001/jama.2020.6775. - DOI - PMC - PubMed
    1. Xiaochen L, Shuyun XU, Muqing Y, Wang K, Tao Y, Zhou Y, et al. Risk-factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110–118. doi: 10.1016/j.jaci.2020.04.006. - DOI - PMC - PubMed
    1. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceassed patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368:m1091. doi: 10.1136/bmj.m1091. - DOI - PMC - PubMed
    1. Tian W, Jiang W, Yao J, Nicholson CJ, Li RH, Haakon H, et al. Predictors of mortality in hospitalized COVID-19 patients: a systematic review and meta-analysis. J Med Virol. 2020 doi: 10.1002/jmv.26050. - DOI - PMC - PubMed