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Risk factors associated with 28-day all-cause mortality in older severe COVID-19 patients in Wuhan, China: a retrospective observational study.
Jiang, Yi; Abudurexiti, Subi; An, Meng-Meng; Cao, Da; Wei, Jie; Gong, Ping.
  • Jiang Y; Department of Emergency, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China.
  • Abudurexiti S; Department of Emergency, General Hospital of Tianjin Medical University, Tianjin, 300052, China.
  • An MM; Department of Emergency, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China.
  • Cao D; Intensive Care Unit, Affiliated Dalian Friendship Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
  • Wei J; Department of Emergency, Southeast University Zhongda Hospital, Nanjing, 210009, Jiangsu, China.
  • Gong P; Department of Emergency, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China. weijie996@sina.com.
Sci Rep ; 10(1): 22369, 2020 12 22.
Article in English | MEDLINE | ID: covidwho-997944
ABSTRACT
We aimed to analyse clinical characteristics and identify risk factors predicting all-cause mortality in older patients with severe coronavirus disease 2019 (COVID-19). A total of 281 older patients with severe COVID-19 were categorized into two age groups (60-79 years and ≥ 80 years). Epidemiological, clinical, and laboratory data, and outcome were obtained. Patients aged ≥ 80 years had higher mortality (63.6%) than those aged 60-79 years (33.5%). Anorexia and comorbidities including hypertension, diabetes and COPD, higher levels of lactate dehydrogenase (LDH), osmotic pressure, C-reactive protein, D-dimer, high-sensitivity troponin I and procalcitonin, and higher SOFA scores were more common in patients aged > 80 years than those aged 60-79 years and also more common and higher in non-survivors than survivors. LDH, osmotic pressure, C-reactive protein, D-dimer, high-sensitivity troponin I, and procalcitonin were positively correlated with age and sequential organ failure assessment (SOFA), whereas CD8+ and lymphocyte counts were negatively correlated with age and SOFA. Anorexia, comorbidities including hypertension, diabetes, and chronic obstructive pulmonary disease (COPD), LDH, osmotic pressure, and SOFA were significantly associated with 28-day all-cause mortality. LDH, osmotic pressure and SOFA were valuable for predicting 28-day all-cause mortality, whereas the area under the receiver operating characteristic curve of LDH was the largest, with sensitivity of 86.0% and specificity of 80.8%. Therefore, patients with severe COVID-19 aged ≥ 80 years had worse condition and higher mortality than did those aged 60-79 years, and anorexia and comorbidities including hypertension, diabetes, COPD, elevated plasma osmotic pressure, LDH, and high SOFA were independent risk factors associated with 28-day all-cause mortality in older patients with severe COVID-19. LDH may have the highest predictive value for 28-day all-cause mortality in all examined factors.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Dysfunction Scores / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Sci Rep Year: 2020 Document Type: Article Affiliation country: S41598-020-79508-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Dysfunction Scores / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Sci Rep Year: 2020 Document Type: Article Affiliation country: S41598-020-79508-3