Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective?

BACKGROUNDS: To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients. METHODS: Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-19; not candidate to intensive care unit admission. Clinical data were collected from patients electronic medical records. Data on 30-day mortality were retrieved from the hospital administrative database. RESULTS: Patients included (N = 294) were on average 83.4 ± 6.7 years old, 50.7% were women, and 21.7% were obese (BMI > 30 kg/m2). At 30-day, 85 (28.9%) patients were deceased. Compared to survivors in bivariable analysis, deceased patients were older (84.6 ± 7.6 vs 83.0 ± 6.3 years), more frequently with very complex health status (63.5% vs 39.7%, P < .001), but less frequently obese (13.4% vs 24.9%, P = .033) at admission. Over their stay, deceased patients more frequently (all P < .001) developed radiologic signs of COVID-19 (84.7% vs 58.9%), anorexia (84.7% vs 59.8%), hypernatremia (40.0% vs 10.5%), delirium (74.1% vs 30.1%), and need for oxygen (87.1% vs 46.4%) compared to survivors. In multivariable analysis that controlled for all markers of poor prognosis identified in bivariable analysis, obese patients remain with 64% (adjOR 0.36, 95%CI 0.14-0.95, P = .038) lower odds to be deceased at 30-day than non-obese patients. CONCLUSIONS: In this population of older COVID-19 inpatients, an inverse association between obesity and 30-day mortality was observed even after adjusting for all already-known markers of poor prognosis. This result challenges previous observations in younger cohorts and would need to be replicated.

Effectiveness of Information Sessions About COVID-19 Vaccines in Healthcare Professionals Working in Geriatrics.

Objectives: To determine change in (a) perceived knowledge about COVID-19 vaccines; (b) level of confidence in transmitting information about vaccines; and (c) intention to get vaccinated; among healthcare professionals (HCP) working in a Swiss academic geriatric department who attended a 30-minute information session about COVID-19 vaccines. Measurements: At the session's end, a self-administered questionnaire collected information about socio-demographics, personnel, and/or relatives' experience with COVID-19. In addition, participants were asked to rate their: (a) perceived knowledge about COVID-19 vaccines; (b) level of confidence in transmitting information about COVID-19 vaccines to patients and relatives; and (c) intention to get vaccinated; before and after the session. Results: Overall, 97 (42.2% of all HCPs) participated to 14 sessions and completed the questionnaire. Improvements were observed in knowledge, confidence in providing information, and intention to be vaccinated after the session (all p < .001). Similar improvements were observed in subgroup analyses by gender, age groups, profession (involved in direct care or not), and previous experience with COVID-19 (all p < .010). However, HCP aged 20 to 29 years were less likely to feel completely confident in providing information than those aged 30 to 49 and 50+ years (17.1% vs. 43.2% vs. 44.0%, respectively, p = .031) and to report being very likely to be vaccinated (31.4% vs. 56.8% vs. 56.0%, respectively, p = .060). Conclusions: These information sessions positively influenced HCP knowledge, confidence in providing information, and, to a lesser extent, intention to be vaccinated. Younger HCP reported similar improvements but remained less likely to consider vaccination. Additional efforts are needed to convince these undecided HCP and enhance COVID-19 vaccines uptake.