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COVID-19 in elderly: Correlations of viral load, clinical course, laboratory parameters, among patients vaccinated
Sabri Engin Altintop1, Tugce Unalan-Altintop2, Mustafa Cihangiroglu3
11Suluova State Hospital, Department of Internal Medicine, Amasya, Turkey.
Insights
Elderly COVID-19 patients vaccinated with CoronaVac experienced shorter hospital stays. Key laboratory markers like CRP and LDH can help predict disease severity in older adults.
Area of Science:
- Virology
- Immunology
- Geriatric Medicine
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, disproportionately affects the elderly.
- In Turkey, elderly populations were primarily vaccinated with the CoronaVac whole virion inactivated vaccine.
- COVID-19 severity in older adults is linked to pneumonia and hypoxemia.
Purpose of the Study:
- To examine the relationship between viral load, laboratory findings, and COVID-19 disease severity in elderly patients (over 60).
- To assess the impact of CoronaVac vaccination status on disease outcomes in this demographic.
Main Methods:
- Retrospective analysis of elderly COVID-19 patients (61-97 years old).
- Comparison of viral load in nasopharyngeal swabs between vaccinated and unvaccinated individuals.
- Evaluation of laboratory parameters (CRP, PLR, fibrinogen, ferritin, LDH) and hospitalization data (including ICU admission).
Main Results:
- Vaccinated patients showed a trend towards lower viral load during breakthrough infections.
- Vaccinated individuals had significantly shorter hospital ward stays (P = 0.035).
- Severe/critical cases exhibited higher levels of CRP, PLR, fibrinogen, ferritin, and LDH compared to moderate cases.
Conclusions:
- CoronaVac vaccination in the elderly is associated with reduced hospitalization duration.
- Laboratory markers such as CRP, PLR, fibrinogen, ferritin, and LDH are potential indicators of COVID-19 severity in older adults.
- Vaccination status did not significantly correlate with the proportion of patients in moderate, severe/critical, or ICU groups.
Abstract:
SARS-CoV-2 virus was initially identified in Wuhan, China, in December 2019 and a global pandemic was declared in March 2020 by World Health Organization. COVID-19 disease is characterized with severe pneumonia and hypoxemia, especially in the elderly population. The elderly population was primarily vaccinated with CoronaVac, which is a whole virion inactivated vaccine (Sinovac Biotech, China) in Turkey. This study aimed to investigate the association of viral load and laboratory parameters with the severity of the disease and vaccination status in elderly (older than 60 years old) COVID-19 patients. The age range of the patients was 61-97 years old with a mean of 71.80. Vaccinated patients had a lower viral load (P = 0.253) in nasopharyngeal swabs during breakthrough COVID-19 infection compared to unvaccinated ones and were hospitalized for a shorter period of time in hospital wards (P = 0.035). A lower number of patients were vaccinated in both moderate (n = 33, 29.20%) and severe/critical group (n = 46, 34.07%) (P = 0.412). Only 17 (32.08%) vaccinated patients were hospitalized in an intensive care unit (ICU), whereas 36 (67.92%) of the ICU patients were unvaccinated (P = 0.931). Severe/critical patients had higher c-reactive protein (CRP), platelet-to-lymphocyte ratio (PLR), fibrinogen, ferritin, and lactate dehydrogenase (LDH) levels compared to the moderate group on the admission day (P < 0.05). Our study suggested that elderly patients vaccinated with CoronaVac had a shorter stay in hospitals and according to our results CRP, PLR, fibrinogen, ferritin, and LDH levels could be used to determine the severity of the infections.
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