Clinical and Epidemiological Characteristics of Elderly Patients with Coronavirus Disease-19 at a Tertiary Care Center in South India

Abstract

Objective: To evaluate the clinical features and laboratory profile of elderly patients with Coronavirus Disease-19 (COVID-19) at a tertiary care centre in South India. Material and Methods: A hospital-based retrospective study was conducted in 1,744 elderly patients by collecting the clinical and laboratory data from COVID-19 confirmed patients from May 2020 to June 2021 in a tertiary care hospital in Bangalore, India. The clinical features, comorbidities, serum biochemical parameters and inflammatory markers were recorded and collated with disease outcomes. The clinical presentation, inflammatory markers were studied and compared between survivors and non-survivors. P-value less than 0.05 set as statistical significance. Results: The mean age of the patients was 69.7±7.4 years and the male: female ratio was 1.65:1. The most common comorbidity reported in elderly patients with COVID-19 was type 2 diabetes mellitus (46.8%), followed by hypertension (35.7%), chronic kidney disease (10.7%), and ischemic heart disease (6.47%). 41.9% of the patients did not have any co-morbidities. Out of the 1,744 elderly patients, 164 (9.4%) died and mortality was highest in the COVID-19 patients with severe disease (103 patients, 62.8%). Inflammatory markers of neutrophil/lymphocyte ratio (N/L ratio), lactate dehydrogenase (LDH), ferritin, C-reactive protein (CRP), D-Dimers and interleukin-6 were significantly elevated among the patients who did not survive. Conclusion: Mortality was highest in elderly COVID-19 patients with severe disease and most of the patients who died had one or more comorbidities. Neutrophilia, lymphopenia, eosinopenia along with elevated N/L ratio, LDH, ferritin, D-dimer, IL-6 and CRP were significantly associated with adverse disease outcomes.