Covid-19 in older adults: Inpatient outcomes in a level 3 irish hospital

ABSTRACT

Background: COVID-19 has proved devastating in older persons. Previous studies reveal a mortality rate of 31% for hospitalised patients over 70.1 We examine outcomes for older COVID patients in our hospital. Methods: We conducted a Hospital In Patient Enquiry Scheme review for patients coded as COVID-19 between 19/03/2020-19/02/2021 (n=674). Older adults were defined as those aged over 65 years at time of admission. Age, sex, length of stay and survival were collected. Data was collated by 'wave' (Wave 1 n=294, 2 n=105, 3 n=275). We reviewed whether patients had a CT pulmonary angiogram (CTPA) on the National Integrated Medical Imaging System. Results: 42.3% of COVID patients in our hospital were older persons (n=285). This remained stable throughout the pandemic (Wave 1 44.2%,Wave 2 44.7%,Wave 3 39.3%). Mean length of stay was 19.7 days for older adults vs 7.4 for those under 65. Older persons had a higher mortality rate at 30.9% vs 3.6%. Overall incidence of PE was low at 1.9% (1.1% in older persons). However, the likelihood of a CTPA being positive for those over 65 was much higher at 42.9% vs 17.9%. While there was improvement in mortality rates in older persons from Wave 1 (31.5%) to 2 (19.1%), our data showed a significant rise in mortality inWave 3 (35.2%). This compares to a different pattern in younger people, with mortality rates by wave at 6.7%, 0% and 1.7%. Conclusion: In a large Irish cohort of patients hospitalised with COVID-19, 42.3% were older adults. Length of hospital stay was 3 times longer and mortality was 10 times higher than patients under 65.Older adults were alsomore likely to have a positive CTPA. Further study is needed to evaluate the long term effects of COVID-19 in our older population.