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Risk Factors for Mortality and Respiratory Support in Elderly Patients Hospitalized with COVID-19 in Korea.
Lee, Ji Yeon; Kim, Hyun Ah; Huh, Kyungmin; Hyun, Miri; Rhee, Ji Young; Jang, Sukbin; Kim, Ji Yeon; Peck, Kyong Ran; Chang, Hyun Ha.
  • Lee JY; Division of Infectious Diseases, Department of Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea.
  • Kim HA; Division of Infectious Diseases, Department of Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea.
  • Huh K; Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • Hyun M; Division of Infectious Diseases, Department of Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea.
  • Rhee JY; Division of Infectious Diseases, Department of Medicine, Dankook University School of Medicine, Cheonan, Korea.
  • Jang S; Division of Infectious Diseases, Department of Medicine, Dankook University School of Medicine, Cheonan, Korea.
  • Kim JY; Division of Infectious Diseases, Department of Medicine, Seongnam Citizens Medical Center, Seongnam, Korea.
  • Peck KR; Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. krpeck@skku.edu.
  • Chang HH; Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. changhha@knu.ac.kr.
J Korean Med Sci ; 35(23): e223, 2020 Jun 15.
Article in English | MEDLINE | ID: covidwho-598889
ABSTRACT

BACKGROUND:

The mortality risk of coronavirus disease 2019 (COVID-19) is higher in patients with older age, and many elderly patients are reported to require advanced respiratory support.

METHODS:

We reviewed medical records of 98 patients aged ≥ 65 years who were hospitalized with COVID-19 during a regional outbreak in Daegu/Gyeongsangbuk-do province of Korea. The outcome measures were in-hospital mortality and the treatment with mechanical ventilation (MV) or high-flow nasal cannula (HFNC).

RESULTS:

The median age of the patients was 72 years; 55.1% were female. Most (74.5%) had at least one underlying condition. Overall case fatality rate (CFR) was 20.4%, and median time to death after admission was 8 days. The CFR was 6.1% among patients aged 65-69 years, 22.7% among those aged 70-79 years, and 38.1% among those aged ≥ 80 years. The CFR among patients who required MV was 43.8%, and the proportion of patients received MV/HFNC was 28.6%. Nosocomial acquisition, diabetes, chronic lung diseases, and chronic neurologic diseases were significant risk factors for both death and MV/HFNC. Hypotension, hypoxia, and altered mental status on admission were also associated with poor outcome. CRP > 8.0 mg/dL was strongly associated with MV/HFNC (odds ratio, 26.31; 95% confidence interval, 7.78-88.92; P < 0.001), and showed better diagnostic characteristics compared to commonly used clinical scores.

CONCLUSION:

Patients aged ≥ 80 years had a high risk of requiring MV/HFNC, and mortality among those severe patients was very high. Severe initial presentation and laboratory abnormalities, especially high CRP, were identified as risk factors for mortality and severe hospital course.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Respiratory Insufficiency / Coronavirus Infections / Hypoxia Type of study: Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: J Korean Med Sci Journal subject: Medicine Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Respiratory Insufficiency / Coronavirus Infections / Hypoxia Type of study: Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: J Korean Med Sci Journal subject: Medicine Year: 2020 Document Type: Article