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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Mortality and functional outcomes 18 months after hospitalization for COVID-19 in geriatric patients: a multicentric
Marion Claes1, Bastien Genet2,3, Audrey Rouet4
1Service de gériatrie aigue / UPREG, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Paris, France.
Insights
Geriatric patients hospitalized for COVID-19 did not experience higher long-term mortality compared to those hospitalized for other reasons. This study found no significant difference in mortality or functional status 18 months post-discharge.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Epidemiology
Background:
- Limited data exist on long-term outcomes for elderly patients after COVID-19 hospitalization.
- This study addresses the long-term mortality and functional status of geriatric survivors post-COVID-19 hospitalization.
Purpose of the Study:
- To compare 18-month mortality and functional status in geriatric patients hospitalized for COVID-19 versus other diagnoses.
- To investigate the long-term impact of COVID-19 on elderly patient survival and independence.
Main Methods:
- Multicenter cohort study in Paris (January-June 2021).
- Included patients aged 75+ hospitalized with or without COVID-19.
- Assessed vital and functional status at 18 months post-hospitalization.
Main Results:
- COVID-19 patients were younger and less frail at baseline.
- At 18 months, 50.8% of COVID-19 patients died vs. 66% of non-COVID-19 patients (p=0.03).
- Multivariate analysis showed no significant association between COVID-19 and 18-month mortality; functional status did not differ.
Conclusions:
- Positive COVID-19 status was not associated with excess long-term mortality in geriatric patients discharged alive.
- COVID-19 hospitalization did not lead to worse long-term survival or functional decline compared to other hospitalizations in this cohort.
Background:
Few data are available on the long-term mortality and functional status of geriatric patients surviving after hospitalization for COVID-19. We compared the mortality and functional status 18 months after hospitalization for geriatric patients who were hospitalized for COVID-19 or another diagnosis.
Methods:
This was a multicentric cohort study in Paris from January to June 2021. We included patients aged 75 years and over who were hospitalized with COVID-19 or not during this period and compared their vital and functional status 18 months after hospitalization.
Results:
We included 254 patients (63 hospitalized for COVID-19). As compared with patients hospitalized for other reasons, those hospitalized for COVID-19 were younger (mean [SD] age 86 [6.47] vs. 88 [6.41] years, p = 0.03), less frail (median Clinical Frailty Scale score 5 [4-6] vs. 6 [4-6], p 0.007) and more independent at baseline (median activities of daily living score 5.5 [4-6] vs. 5 [3.5-6], p 0.03; instrumental activities of daily living score 3 [1-4] vs. 2 [0-3], p 0.04). At 18 months, 50.8% (n = 32/63) of COVID-19 patients had died versus 66% (n = 126/191) of non-COVID-19 patients (p 0.03). On multivariate analysis, COVID-19 positivity was not significantly associated with 18-month mortality (adjusted hazard ratio 0.67, 95% confidence interval 0.40 to 1.13). At 18 months, the two groups did not differ in activities of daily living or frailty scores.
Conclusions:
In this multicenter study of long-term mortality in geriatric patients discharged alive after hospitalization, positive COVID-19 status was not associated with excess mortality.
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