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BACKGROUND AND OBJECTIVES: Multiple scoring systems were used for risk stratification in COVID-19 patients. The objective was to determine among 6 scores which performed the best in predicting short-and long-term mortality in hospitalized COVID-19 patients ≥ 60 years. METHODS: An observational, retrospective cohort study conducted between 21/10/2020 and 20/01/2021. 6 scores were calculated (Clinical Frailty Scale (CFS), Charlson Comorbidity Index (CCI), 4C Mortality Score (4CMS), NEWS score (NEWS), quick-SOFA score (qSOFA), and Quick COVID-19 Severity Index (qCSI)). We included unvaccinated hospitalized patients with COVID-19 ≥ 60 years old in Brugmann hospital, detected by PCR and/or suggestive CT thorax images. Old and nosocomial infections, and patients admitted immediately at the intensive care unit were excluded. RESULTS: 199 patients were included, mean age was 76.2 years (60-99). 47.2% were female. 56 patients (28%) died within 1 year after the first day of hospitalization. The 4CMS predicted the best intrahospital, 30 days and 6 months mortality, with area under the ROC curve (AUROC) 0.695 (0.58-0.81), 0.76 (0.65-0.86) and 0.72 (0.63-0.82) respectively. The CCI came right after with respectively AUROC of 0.69 (0.59-0.79), 0.74 (0.65-0.83) and 0.71 (0.64-0.8). To predict mortality at 12 months after hospitalization, the CCI had the highest AUROC with 0.77 (0.69-0.85), before the 4CMS with 0.69 (0.60-0.79). DISCUSSION: Among 6 scores, the 4CMS was the best to predict intrahospital, 30-day and 6-month mortality. To predict mortality at 12 months, CCI had the best performance before 4CMS. This reflects the importance of considering comorbidities for short- and long-term mortality after COVID 19. REGISTRATION: This study was approved by the ethical committee of Brugmann University Hospital (reference CE 2020/228).
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OBJECTIVE: We aimed at assessing the association between demographical and clinical data and the intrahospital mortality in older patients with COVID-19 in Belgium. METHODS: Descriptive, retrospective study of consecutive patients admitted to Brugmann university hospital, Brussels (Belgium) due to COVID-19 (Mars-September-2020). INCLUSION CRITERIA: Patients aged ≥ 70 years admitted to acute care with a positive PCR-RT test, or a highly indicative computed tomography scan. EXCLUSION CRITERIA: Patients transferred to another institution during hospitalization. OUTCOME MEASURE: All-cause intrahospital mortality. Demographic, clinical data, presence of comordibidties and comprehensive geriatric assessment were collected. Adjusted and unadjusted logistic regression were performed. RESULTS: From the 226 eligible patients, 160 (82.7 ± 6.5-year-old; 57.5 % females) met inclusion criteria, from which 67 (42 %) died during hospital stay. The adjusted logistic regression showed an association between intrahospital mortality and increasing age [OR = 1.09 per every year increase (95 % CI 1.02-1.16); p <0.001], type 2 diabetes [OR = 2.75 ( 1.17-6.46); p = 0.021], and acute respiratory distress syndrome (ARDS) [OR = 8.67 ( 3.48-21.61); p < 0.01]. CONCLUSIONS: A higher positive association between intrahospital mortality and increasing age, type 2 diabetes, and ARDS was found. The prognosis value of the comprehensive geriatric assessment in older people with COVID-19 in Belgium requires further studies.
INTRODUCTION: Les études sur l'impact de la pandémie en Belgique sont rares. L'objectif est d'évaluer l'association de l'âge et des comorbidités à la mortalité intra-hospitalière de toutes causes chez les patients âgés ? 70 ans avec COVID-19 dans un hôpital universitaire à Bruxelles, Belgique. Méthodes : Etude rétrospective descriptive des patients admis au CHU Brugmann pour cause de maladie COVID-19 (mars-septembre 2020). Critères d'inclusion : âge ≥ 70 ans admis avec PCR-RT positif ou haute probabilité d'infection au CT-scan thoracique. Critères d'exclusion : transfert dans un autre hôpital. Critère de jugement : toute cause de mortalité intra-hospitalière. Variables collectées : démographiques, cliniques et gériatriques [Katz, Lawton, MMSE, MNA, MNA-SF]. Une régression logistique non ajustée et ajustée a été réalisée. Résultats : Parmi les 226 patients éligibles, 160 (82,7 ± 6,5 ans; 57,5 % femmes) ont rempli les critères d'inclusion. Au total, 67 (42 %) sont décédés durant l'hospitalisation. La régression logistique a montré une association augmentée entre la mortalité et l'âge [odds ratio ou OR = 1,09/année en plus (IC 95 % 1,02-1,16) ; p< 0,001], le diabète de type 2 [OR = 2,75 (1,17-6,46); p = 0,021], l'ARDS [OR = 8,67 (3,48-21,61); p < 0,01]. CONCLUSION: L'âge, le diabète de type 2 et le syndrome de détresse respiratoire aiguë (ARDS) sont associés à une augmentation de la mortalité chez les patients âgés hospitalisés avec COVID-19 en Belgique.
