Study risk factors, clinical profile, and outcome in hospitalized COVID-19 geriatric patients.

Abstract

Background: Coronaviruses are from the family of viruses that cause respiratory illness in humans. Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and the common cold are examples of coronaviruses that cause illness in humans. COVID-19, the new strain of coronavirus was first reported in Wuhan, China in December 2019. The virus has since spread all over the world creating havoc. The zoonotic origin of the virus has been a significant area of investigation. The infected person spreads the virus to two or three other people in a chain reaction-like pattern. India, like many countries, experienced a significant number of confirmed cases and deaths.Variations in fatality rates were observed globally.

Purpose: The aim of the study is to study risk factors, clinical profile, and outcomes in hospitalized elderly (age >60) with COVID-19 and the correlation of disease severity with comorbidities and laboratory and radiological parameters by comparing the differences between young elderly (60-70 years old), old elderly (71-80 years old), and very old elderly (>81 years old). It is important to identify the risk factors and high-risk groups to aid early, aggressive intervention, facilitate equitable hospital resources, and alleviate the critical care crisis that has arisen in the country and the world.

Method: This is a retrospective observational study of all the hospitalized elderly patients (>60 years old) who were diagnosed with COVID-19 and admitted to a tertiary care hospital from April 1, 2020, to December 31, 2020. Data such as clinical history along with associated comorbidities, clinical parameters, radiological imaging, signs and symptoms, treatment given and oxygen requirements, and hospital stay including ICU were collected from a computer-based data acquisition system.

Conclusion: Out of 654 confirmed hospitalized elderly patients with COVID-19, 60.1% (n = 393) were young adults, 31.2% (n = 204) were old adults and 8.7% (n = 57) were very old adults. Among these, hypertension, diabetes mellitus, hypothyroidism, and chronic artery disease (CAD) were the most common comorbidities in the data collected. The frequent symptoms observed were fever in almost 89% of the patient's upper respiratory tract infection (which commonly includes sore throat, nasal stuffiness, runny nose, and cough) was observed in more than 60% of the admitted patients, and approximately 20% of the patient's complaint of shortness of breath (SOB). Adults above 60 years are considered vulnerable group who are more prone to develop severe disease and tend to have more complications as the age increases. The number of ICU admissions is also amplified with age and related comorbidity. It is observed in the study that the duration of hospital stay is reduced significantly with the advent of antiviral use such as Remdesivir and other experimental protocols including plasma therapy and tocilizumab in COVID-19. The clinical parameters such as elevated ferritin, CRP, D-dimers, lymphocytopenia, and CTSS are important to determine the severity of the ongoing disease in the patients.