1. Characteristics and Outcomes of Patients 80 Years and Older Hospitalized With Coronavirus Disease 2019 (COVID-19).
- Author
-
Nabors C, Sridhar A, Hooda U, Lobo SA, Levine A, Frishman WH, and Dhand A
- Subjects
- Academic Medical Centers, Accidental Falls, Acute Kidney Injury etiology, Aged, 80 and over, Arrhythmias, Cardiac etiology, Arrhythmias, Cardiac physiopathology, Aspartate Aminotransferases metabolism, C-Reactive Protein metabolism, COVID-19 complications, COVID-19 metabolism, COVID-19 physiopathology, Cardiovascular Diseases etiology, Cardiovascular Diseases metabolism, Cardiovascular Diseases physiopathology, Cause of Death, Consciousness Disorders physiopathology, Dyspnea physiopathology, Female, Ferritins metabolism, Fever physiopathology, Fibrin Fibrinogen Degradation Products metabolism, Hospitalization, Humans, Hypoxia physiopathology, Hypoxia therapy, Independent Living, Intensive Care Units statistics & numerical data, Intracranial Hemorrhages etiology, Intracranial Hemorrhages physiopathology, Leukocyte Count, Liver Diseases etiology, Liver Diseases metabolism, Lymphocyte Count, Male, Muscle Weakness physiopathology, Natriuretic Peptide, Brain metabolism, Nursing Homes, Oxygen Inhalation Therapy, Procalcitonin metabolism, Stroke etiology, Stroke physiopathology, Troponin I metabolism, Acute Kidney Injury therapy, COVID-19 therapy, Hospital Mortality, Renal Replacement Therapy statistics & numerical data, Respiration, Artificial statistics & numerical data, Vasoconstrictor Agents therapeutic use
- Abstract
Patients older than 65 years hospitalized with COVID-19 have higher rates of intensive care unit admission and death when compared with younger patients. Cardiovascular conditions associated with COVID-19 include myocardial injury, acute myocarditis, cardiac arrhythmias, cardiomyopathies, cardiogenic shock, thromboembolic disease, and cardiac arrest. Few studies have described the clinical course of those at the upper extreme of age. We characterize the clinical course and outcomes of 73 patients with 80 years of age or older hospitalized at an academic center between March 15 and May 13, 2020. These patients had multiple comorbidities and often presented with atypical clinical findings such as altered sensorium, generalized weakness and falls. Cardiovascular manifestations observed at the time of presentation included new arrhythmia in 7/73 (10%), stroke/intracranial hemorrhage in 5/73 (7%), and elevated troponin in 27/58 (47%). During hospitalization, 38% of all patients required intensive care, 13% developed a need for renal replacement therapy, and 32% required vasopressor support. All-cause mortality was 47% and was highest in patients who were ever in intensive care (71%), required mechanical ventilation (83%), or vasopressors (91%), or developed a need for renal replacement therapy (100%). Patients older than 80 years old with COVID-19 have multiple unique risk factors which can be associated with increased cardiovascular involvement and death.
- Published
- 2021
- Full Text
- View/download PDF