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Effects of Comorbid Factors on Prognosis of Three Different Geriatric Groups with COVID-19 Diagnosis
1Department of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Varlık Mh. Kazım Karabekir Cd, 07100 Antalya, Turkey.
Insights
Older adults face severe COVID-19 outcomes. This study found that increasing age, specific comorbidities like malignancy, and ground glass opacity on CT scans significantly increase mortality risk in elderly COVID-19 patients.
Area of Science:
- Gerontology
- Infectious Diseases
- Radiology
Background:
- Coronavirus disease 2019 (COVID-19) poses a significant threat to global health, particularly impacting elderly populations due to higher rates of multimorbidity.
- Geriatric age groups are disproportionately affected by severe COVID-19 outcomes, necessitating a deeper understanding of prognostic factors.
Purpose of the Study:
- To analyze the impact of age, comorbidities, symptoms, and radiological findings on COVID-19 prognosis in different geriatric age groups.
- To identify key predictors of mortality and intensive care unit (ICU) admission among elderly patients with COVID-19.
Main Methods:
- Retrospective descriptive analysis of 483 COVID-19 patients.
- Patients were stratified into three geriatric groups: 65-74 years (young-old), 75-84 years (middle-aged), and 85+ years (oldest-elderly).
- Statistical analysis was employed to determine the significance of various factors on patient outcomes.
Main Results:
- Patients aged 75-84 had higher ICU length of stay (p=0.013).
- Mortality rates were lowest in the 65-74 age group (p<0.001) and increased significantly with age (75-84: OR 2.602; 85+: OR 4.086).
- Ground glass opacity on CT scans correlated with increased mortality (p<0.001), while COPD-bronchial asthma was associated with survival (p=0.001). Malignancy and cerebrovascular disease were linked to higher mortality (p<0.005, p<0.001).
Conclusions:
- Age is a critical prognostic factor in COVID-19, with significantly higher mortality risk in patients aged 75 and older.
- Radiological findings like ground glass opacity and comorbidities such as malignancy and cerebrovascular disease are strong indicators of poor prognosis.
- Certain comorbidities (COPD-bronchial asthma) and symptoms (fatigue, dry cough) were associated with better outcomes, suggesting nuanced disease progression within geriatric populations.
Abstract:
Coronavirus disease 2019 (COVID-19) is a new zoonotic infectious disease that was first reported to the World Health Organization (WHO) on December 31, 2019, and declared as a pandemic by WHO on March 11, 2020. Due to the increased incidence of multimorbidity in geriatric age groups, COVID-19 disease leads to more severe consequences in the elderly. We aimed to determine the effects of age, comorbidity factors, symptoms, laboratory findings, and radiological results on prognosis by dividing our patients into 3 different geriatric age groups, using a retrospective descriptive analysis method. Patients included in the retrospective study (n = 483) were divided into the following three different geriatric age groups: young-old (65-74 years), middle-aged (75-84 years), and the oldest-elderly (85 years and over).The length of stay in the intensive care unit of the patients between the ages of 75-84 was higher than the other two groups (p = 0.013). Mortality rates were lowest in patients aged 65-74 years (p < 0.001). The rate of ground glass opacity in thorax CT was higher in patients with mortality (p < 0.001). While the rate of COPD-bronchial asthma was higher in surviving patients (p = 0.001), malignancy (p = 0.005) and cerebrovascular disease (p < 0.001) were higher in patients who died. Patients aged between 75 and 84 (OR: 2.602; 95% CI: 1.306-5.183; p = 0.007) or ≥ 85 (OR: 4.086; 95% CI: 1.687-9.9; p = 0.002) had higher risk for mortality compared to patients aged between 65 and 74. The lowest mortality rates were observed in patients aged 65-74 years. Among the supportive diagnostic methods in 3 different geriatric age groups, PCR positivity has no effect on mortality, while the ground glass opacity on tomography is closely related to the need for intensive care and increased mortality. In patients with COPD-bronchial asthma comorbidity and those with symptoms of fatigue, dry cough, and sore throat, transfer to intensive care and mortality rates were lower, while patients who were transferred to intensive care and who developed mortality had higher malignancy and cerebrovascular disease comorbidities and dyspnea symptoms.
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