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Association of health vulnerability with adverse outcomes in older people with COVID-19: a prospective cohort study
Assis, Fábio Cavalcante de; Silva, Michelle Cristina-Oliveira da; Geber-Júnior, João Carlos; Roschel, Hamilton; Peçanha, Tiago; Drager, Luciano Ferreira; Santana, Alfredo Nicodemos Cruz.
Afiliação
  • Assis, Fábio Cavalcante de; Universidade de Brasília (UnB). Faculdade de Medicina. Departamento de Clinica Medica, Disciplina de Medicina de Emergencia. Brasilia. BR
  • Silva, Michelle Cristina-Oliveira da; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Clinica Medica, Disciplina de Reumatologia, Hospital das Clinicas HCFMUSP. Sao Paulo. BR
  • Geber-Júnior, João Carlos; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Clinica Medica, Disciplina de Clinica Geral e Propedeutica, Hospital das Clinicas HCFMUSP. Sao Paulo. BR
  • Roschel, Hamilton; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Clinica Medica, Disciplina de Reumatologia, Hospital das Clinicas HCFMUSP. Sao Paulo. BR
  • Peçanha, Tiago; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Clinica Medica, Disciplina de Reumatologia, Hospital das Clinicas HCFMUSP. Sao Paulo. BR
  • Drager, Luciano Ferreira; Universidade de Sao Paulo. Faculdade de Medicina. Unidade de Hipertensao, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP. Sao Paulo. BR
  • Santana, Alfredo Nicodemos Cruz; Escola de Ciencias da Saude (ESCS). Brasilia. BR
Clinics ; Clinics;76: e3369, 2021. tab, graf
Article em En | LILACS | ID: biblio-1350614
Biblioteca responsável: BR1.1
ABSTRACT

OBJECTIVES:

Health vulnerability is associated with a higher risk of mortality and functional decline in older people in the community. However, few studies have evaluated the role of the Vulnerable Elders Survey (VES-13) in predicting clinical outcomes of hospitalized patients. In the present study, we tested the ability of the VES-13 to predict mortality and the need for invasive mechanical ventilation in older people hospitalized with coronavirus disease 2019 (COVID-19).

METHODS:

This prospective cohort included 91 participants aged ≥60 years who were confirmed to have COVID-19. VES-13 was applied, and the demographic, clinical, and laboratory variables were collected within 72h of hospitalization. A Poisson generalized linear regression model with robust variance was used to estimate the relative risk of death and invasive mechanical ventilation.

RESULTS:

Of the total number of patients, 19 (21%) died and 15 (16%) required invasive mechanical ventilation. Regarding health vulnerability, 54 (59.4%) participants were classified as non-vulnerable, 30 (33%) as vulnerable, and 7 (7.6%) as extremely vulnerable. Patients classified as extremely vulnerable and male sex were strongly and independently associated with a higher relative risk of in-hospital mortality (p<0.05) and need for invasive mechanical ventilation (p<0.05).

CONCLUSION:

Elderly patients classified as extremely vulnerable had more unfavorable outcomes after hospitalization for COVID-19. These data highlight the importance of identifying health vulnerabilities in this population.
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Texto completo: 1 Índice: LILACS Assunto principal: COVID-19 Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Índice: LILACS Assunto principal: COVID-19 Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2021 Tipo de documento: Article