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Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- a cohort study.
Chinnadurai, Rajkumar; Ogedengbe, Onesi; Agarwal, Priya; Money-Coomes, Sally; Abdurrahman, Ahmad Z; Mohammed, Sajeel; Kalra, Philip A; Rothwell, Nicola; Pradhan, Sweta.
Affiliation
  • Chinnadurai R; Acute Medical Unit, Fairfield General Hospital, Bury, BL9 7TD, UK. rajkumar.chinnadurai@srft.nhs.uk.
  • Ogedengbe O; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK. rajkumar.chinnadurai@srft.nhs.uk.
  • Agarwal P; Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. rajkumar.chinnadurai@srft.nhs.uk.
  • Money-Coomes S; Acute Medical Unit, Fairfield General Hospital, Bury, BL9 7TD, UK.
  • Abdurrahman AZ; Acute Medical Unit, Fairfield General Hospital, Bury, BL9 7TD, UK.
  • Mohammed S; Acute Medical Unit, Fairfield General Hospital, Bury, BL9 7TD, UK.
  • Kalra PA; Acute Medical Unit, Fairfield General Hospital, Bury, BL9 7TD, UK.
  • Rothwell N; Acute Medical Unit, Fairfield General Hospital, Bury, BL9 7TD, UK.
  • Pradhan S; Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
BMC Geriatr ; 20(1): 409, 2020 10 16.
Article in En | MEDLINE | ID: mdl-33066750
BACKGROUND: There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations. METHODS: We describe the clinical characteristics of all consecutive COVID-19 positive patients (n = 215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. RESULTS: The median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p < 0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p < 0.001) and respiratory diseases (group 2: 38 vs group 1: 25%, p = 0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p = 0.03), frailty (OR 5.1; p < 0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p = 0.01) were significant predictors of inpatient mortality. KM curves showed a significantly shorter survival time in the frail older patients. CONCLUSION: Older age and frailty are chief risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pneumonia, Viral / Frail Elderly / Coronavirus Infections / Frailty Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male Language: En Journal: BMC Geriatr Journal subject: GERIATRIA Year: 2020 Document type: Article Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pneumonia, Viral / Frail Elderly / Coronavirus Infections / Frailty Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male Language: En Journal: BMC Geriatr Journal subject: GERIATRIA Year: 2020 Document type: Article Country of publication: United kingdom