Clinical Characteristics and Outcomes of 821 Older Patients With SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards
Lorène Zerah
(1, 2)
,
Édouard Baudouin
(1)
,
Marion Pépin
(3, 4)
,
Morgane Mary
(5)
,
Sébastien Krypciak
(6, 7)
,
Céline Bianco
(8, 9)
,
Swasti Roux
(10)
,
Ariane Gross
(11)
,
Charlotte Toméo
(1)
,
Nadège Lemarié
(12, 13)
,
Antoine Dureau
(14, 13)
,
Sophie Bastiani
(15)
,
Flora Ketz
(16, 13)
,
Clémence Boully
(17)
,
Cédric de Villelongue
(18)
,
Mouna Romdhani
(18)
,
Marie-Astrid Desoutter
(4, 3)
,
Emmanuelle Duron
(5)
,
Jean-Philippe David
(7, 6)
,
Caroline Thomas
(8)
,
Elena Paillaud
(7, 19, 20)
,
Pauline de Malglaive
(11)
,
Eric Bouvard
(12, 13)
,
Mathilde Lacrampe
(14, 13)
,
Elise Mercadier
(15)
,
Alexandra Monti
(16, 13)
,
Olivier Hanon
(17)
,
Virginie Fossey-Diaz
(18)
,
Lauriane Bourdonnec
(18)
,
Bruno Riou
(1, 13, 21)
,
Hélène Vallet
(9, 8)
,
Jacques Boddaert
(9, 1)
1
CHU Pitié-Salpêtrière [AP-HP]
2 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
3 Hôpital Ambroise Paré [AP-HP]
4 CESP - Centre de recherche en épidémiologie et santé des populations
5 Hôpital Paul Brousse
6 CHU Henri Mondor [Créteil]
7 IMRB - Institut Mondor de Recherche Biomédicale
8 CHU Saint-Antoine [AP-HP]
9 CIMI - Centre d'Immunologie et des Maladies Infectieuses
10 Hôpital Corentin Celton [Issy-les-Moulineaux]
11 CIC - CHU Bichat
12 CHU Tenon [AP-HP]
13 SU FM - Sorbonne Université - Faculté de Médecine
14 CHU Rothschild [AP-HP]
15 AP-HP - Hôpital Antoine Béclère [Clamart]
16 CHU Charles Foix [AP-HP]
17 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
18 Hôpital Bretonneau
19 HEGP - Hôpital Européen Georges Pompidou [APHP]
20 U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil]
21 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
2 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
3 Hôpital Ambroise Paré [AP-HP]
4 CESP - Centre de recherche en épidémiologie et santé des populations
5 Hôpital Paul Brousse
6 CHU Henri Mondor [Créteil]
7 IMRB - Institut Mondor de Recherche Biomédicale
8 CHU Saint-Antoine [AP-HP]
9 CIMI - Centre d'Immunologie et des Maladies Infectieuses
10 Hôpital Corentin Celton [Issy-les-Moulineaux]
11 CIC - CHU Bichat
12 CHU Tenon [AP-HP]
13 SU FM - Sorbonne Université - Faculté de Médecine
14 CHU Rothschild [AP-HP]
15 AP-HP - Hôpital Antoine Béclère [Clamart]
16 CHU Charles Foix [AP-HP]
17 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
18 Hôpital Bretonneau
19 HEGP - Hôpital Européen Georges Pompidou [APHP]
20 U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil]
21 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
Caroline Thomas
- Fonction : Auteur
- PersonId : 759522
- ORCID : 0000-0002-3939-9317
Mathilde Lacrampe
- Fonction : Auteur
Alexandra Monti
- Fonction : Auteur
Hélène Vallet
- Fonction : Auteur
- PersonId : 1197639
- IdHAL : helene-vallet
- ORCID : 0000-0002-3593-5055
- IdRef : 185807992
Résumé
Background: There is limited information describing the characteristics and outcomes of hospitalized older patients with confirmed coronavirus disease 2019 (COVID-19).
Methods: We conducted a multicentric retrospective cohort study in 13 acute COVID-19 geriatric wards, from March 13 to April 15, 2020, in Paris area. All consecutive patients aged ≥ 70 years, with confirmed COVID-19, were enrolled.
Results: Of the 821 patients included in the study, the mean (SD) age was 86 (7) years; 58% were female; 85% had ≥ 2 comorbidities; 29% lived in an institution; and the median (interquartile range) Activities of Daily Living Scale (ADL) score was 4 [2-6]. The most common symptoms at COVID-19 onset were asthenia (63%), fever (55%), dyspnea (45%), dry cough (45%) and delirium (25%). The in-hospital mortality was 31% (95% confidence interval [CI], 27 to 33). On multivariate analysis, at COVID-19 onset, the probability of in-hospital mortality was increased with male gender (odds ratio [OR], 1.85; 95% CI, 1.30 to 2.63), ADL score < 4 (OR, 1.84; 95% CI, 1.25 to 2.70), asthenia (OR, 1.59; 95% CI, 1.08 to 2.32), quick Sequential Organ Failure Assessment score ≥ 2 (OR, 2.63; 95% CI, 1.64 to 4.22) and specific COVID-19 anomalies on chest computerized tomography (OR, 2.60; 95% CI, 1.07 to 6.46).
Conclusions: This study provides new information about older patients with COVID-19 who are hospitalized. A quick bedside evaluation at admission of sex, functional status, systolic arterial pressure, consciousness, respiratory rate and asthenia can identify older patients at risk of unfavorable outcomes.