ABSTRACT
Objective: To characterize the geriatric patient profile and identify the mortality-associated factors in a population over 80 years hospitalized with COVID-19 infection in the geriatric ward of a university hospital in the city of Bogota. Material(s) and Method(s): An analytical observational retrospective cohort study based on chart reviews was conducted. The study included patients over 80 years with confirmed COVID-19 infection from March 1, 2020 to February 28, 2021. The dependent variable was mortality and the independent variables were age, clinical factors, baseline characteristics and paraclinical status. Result(s): Two hundred eighty (280) patients with a median age of 84 years, most of whom were overweight, were identified. The most frequent symptom was cough followed by dyspnea. Out of all patients, 60.3 % presented lymphopenia and elevated D-dimer levels (> 1,000 mug/L), and most of them showed typical imaging patterns of COVID-19. Mortality accounted for 41.4 % and was mainly associated with older age, elevated C-reactive protein, activities of daily living impairment, history of major neurocognitive disorder, comorbidity, and dependent and frail patient profiles. Conclusion(s): The geriatric population has an increased risk of mortality from COVID-19 infection. The present study showed that dependent and frail patient profiles, as well as the presence of comorbidities such as major neurocognitive disorder, chronic obstructive pulmonary disease and polypharmacy prior to admission, could influence the outcome. Copyright © 2022 Universidad de San Martin de Porres, Facultad de Medicina. All Rights Reserved.
ABSTRACT
BACKGROUND AND AIM: The clinical presentation and severity of (MIS-C) presents a very low mortality in high-income countries. This research describes clinical characteristics of MIS-C in critically ill children in middleincome countries and factors associated with mortality and critical outcomes. METHOD(S): Observational cohort study in 14 (PICUs) in Colombia between April 2020 -January 2021. Patient age from one month to18 years, that met WHO requirements for MIS-C. RESULT(S): There were 78 children in this study. The median age was seven years (IQR 1-11), 18 % (14/78) were under one year old. 35 % of patients (29/78) were obese or overweight. 100 % had fever upon arrival to the clinic lasting at least five days (IQR 3.7-6). 70 % (55/78) of patients had diarrhea, and 87% (68/78) shock or systolic myocardial dysfunction (78 %), 35% (27/78) coronary aneurysms, and pericardial effusion in 36 %.There was a higher mortality rate compared to high in-come countries (9 % vs. 1.8 %;p=0.001). When assessing the group of patients who died, ferritin levels was above 500 ngr/mL (100 % vs. 45 %;p=0.012), as well as more cardiovascular complications (100 % vs. 54 %;p = 0.019). CONCLUSION(S): MIS-C in critically ill children living in a middle-income country has some clinical, laboratory, and echocardiographic characteristics, similar to high-income countries. Inflammatory response and cardiovascular involvement added to the difficulties in accessing the healthcare system in limited resources countries, could explain the greater mortality seen. Prospective studies are needed to compare the differences found in MIS-C outcomes between countries with different income.