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Multicenter Study
. 2022 Mar 1;51(3):afac048.
doi: 10.1093/ageing/afac048.

Characteristics and outcomes of older patients hospitalised for COVID-19 in the first and second wave of the pandemic in The Netherlands: the COVID-OLD study

Rosalinde A L Smits  1 , Stella Trompet  1 , Carolien M J van der Linden  2 , Jessica M van der Bol  3 , Steffy W M Jansen  2 , Harmke A Polinder-Bos  4 , Hanna C Willems  5 , Dennis G Barten  6 , Laura C Blomaard  1 , Mark G J de Boer  7 , Floor J A van Deudekom  8 , Jacobien L J Ellerbroek  9 , Jan Festen  10 , Esther M M van de Glind  11 , Linda M Kampschreur  12 , Ouafae Karimi  13 , Bart Kroon  4 , Marc G J A van Lanen  14 , Jacinta A Lucke  15 , Huub A A M Maas  16 , Francesco U S Mattace-Raso  17 , Barbara C van Munster  18 , Lisette Reijerse  6 , Sarah H M Robben  16 , Rikje Ruiter  19 , Henrike J Schouten  20 , Petra E Spies  21 , Anna Wassenburg  22 , Marjolein A Wijngaarden  1 , Simon P Mooijaart  1
Affiliations
Multicenter Study

Characteristics and outcomes of older patients hospitalised for COVID-19 in the first and second wave of the pandemic in The Netherlands: the COVID-OLD study

Rosalinde A L Smits et al. Age Ageing. .

Abstract

Background: as the coronavirus disease of 2019 (COVID-19) pandemic progressed diagnostics and treatment changed.

Objective: to investigate differences in characteristics, disease presentation and outcomes of older hospitalised COVID-19 patients between the first and second pandemic wave in The Netherlands.

Methods: this was a multicentre retrospective cohort study in 16 hospitals in The Netherlands including patients aged ≥ 70 years, hospitalised for COVID-19 in Spring 2020 (first wave) and Autumn 2020 (second wave). Data included Charlson comorbidity index (CCI), disease severity and Clinical Frailty Scale (CFS). Main outcome was in-hospital mortality.

Results: a total of 1,376 patients in the first wave (median age 78 years, 60% male) and 946 patients in the second wave (median age 79 years, 61% male) were included. There was no relevant difference in presence of comorbidity (median CCI 2) or frailty (median CFS 4). Patients in the second wave were admitted earlier in the disease course (median 6 versus 7 symptomatic days; P < 0.001). In-hospital mortality was lower in the second wave (38.1% first wave versus 27.0% second wave; P < 0.001). Mortality risk was 40% lower in the second wave compared with the first wave (95% confidence interval: 28-51%) after adjustment for differences in patient characteristics, comorbidity, symptomatic days until admission, disease severity and frailty.

Conclusions: compared with older patients hospitalised in the first COVID-19 wave, patients in the second wave had lower in-hospital mortality, independent of risk factors for mortality.The better prognosis likely reflects earlier diagnosis, the effect of improvement in treatment and is relevant for future guidelines and treatment decisions.

Keywords: COVID-19; frailty; in-hospital mortality; second pandemic wave.

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Figures

Figure 1
Figure 1
Flowchart patient inclusions.
See this image and copyright information in PMC

Comment in

  • COVID-19: lessons learned the hard way.
    Welsh TJ, Tenison E. Welsh TJ, et al. Age Ageing. 2022 Jun 1;51(6):afac132. doi: 10.1093/ageing/afac132. Age Ageing. 2022. PMID: 35751873 Free PMC article. No abstract available.

References

    1. Becerra-Munoz VM, Nunez-Gil IJ, Eid CMet al. Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19. Age Ageing 2021; 50: 326–34. 10.1093/ageing/afaa258. - DOI - PMC - PubMed
    1. Owen RK, Conroy SP, Taub Net al. Comparing associations between frailty and mortality in hospitalised older adults with or without COVID-19 infection: a retrospective observational study using electronic health records. Age Ageing 2021; 50: 307–16. 10.1093/ageing/afaa167. - DOI - PMC - PubMed
    1. Ramos-Rincon JM, Buonaiuto V, Ricci Met al. Clinical characteristics and risk factors for mortality in very old patients hospitalized with COVID-19 in Spain. J Gerontol A Biol Sci Med Sci 2021; 76: e28–37. 10.1093/gerona/glaa243. - DOI - PMC - PubMed
    1. Blomaard LC, Linden CMJ, Bol JMet al. Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study. Age Ageing 2021; 50: 631–40. 10.1093/ageing/afab018. - DOI - PMC - PubMed
    1. Hewitt J, Carter B, Vilches-Moraga Aet al. The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study. Lancet Public Health 2020; 5: e444–51. 10.1016/s2468-2667(20)30146-8. - DOI - PMC - PubMed

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