Risk factors for mortality in 244 older adults with COVID-19 in Wuhan, China: a retrospective study.
J Am Geriatr Soc. 2020 May 08;:
Authors: Sun H, Ning R, Tao Y, Yu C, Deng X, Zhao C, Meng S, Tang F, Xu D
BACKGROUND/OBJECTIVES: Previous studies have reported that older patients may experience worse outcome(s) after infection with severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) than younger individuals. This study aimed to identify potential risk factors for mortality in older patients with coronavirus disease-2019 (COVID-19) on admission, which may help identify those with poor prognosis at an early stage.
DESIGN: Retrospective case-control.
SETTING: Fever ward of Sino-French New City Branch of Tongji Hospital, Wuhan, China.
PARTICIPANTS: Patients ≥60 years of age with COVID-19 (n = 244) were included, of which 123 were discharged and 121 died in hospital.
MEASUREMENTS: Data retrieved from electronic medical records regarding symptoms, signs, and laboratory findings on admission, and final outcomes of all older patients with COVID-19, were retrospectively reviewed. Univariate and multivariate logistic regression analyses were used to explore risk factors for death.
RESULTS: Univariate analysis revealed that several clinical characteristics and laboratory variables were significantly different (i.e., p < .05) between discharged and deceased patients. Multivariable logistic regression analysis revealed that lymphocyte (LYM) count (odds ratio [OR] 0.009 [95% confidence interval (CI) 0.001-0.138]; p = .001) and older age (OR 1.1 22 [95% CI 1.007-1.249]; p = .037) were independently associated with hospital mortality. White blood cell count was also an important risk factor (p = .052). The area under the receiver operating characteristic curve in the logistic regression model was 0.913. Risk factors for in-hospital death were similar between older men and women.
CONCLUSION: Older age and lower LYM count on admission were associated with death in hospitalized COVID-19 patients. Stringent monitoring and early intervention are needed to reduce mortality in these patients. This article is protected by copyright. All rights reserved.
PMID: 32383809 [PubMed - as supplied by publisher]