Vitamin D deficiency and SARS­CoV­2 infection: A retrospective case-Control study with big-data analysis covering March 2020 to March 2021.

BACKGROUND: Vitamin D may have immunomodulatory functions, and might therefore play a role in the pathogenesis of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, no conclusive evidence exists regarding its impact on the prevalence of this infection, the associated course of disease, or prognosis. OBJECTIVE: To study the association between SARS-CoV-2 infection and vitamin D deficiency in patients attending a tertiary university hospital, and to examine the clinical course of infection and prognosis for these patients. METHODS: This non-interventional, retrospective study, which involved big-data analysis and employed artificial intelligence to capture data from free text in the electronic health records of patients diagnosed with SARS-CoV-2, was undertaken at a tertiary university hospital in Madrid, Spain, between March 2020 and March 2021. The variables recorded were vitamin D deficiency, sociodemographic and clinical characteristics, course of disease, and prognosis. RESULTS: Of the 143,157 patients analysed, 36,261 had SARS-CoV-2 infection (25.33%) during the study period, among whom 2,588 (7.14%) had a vitamin D deficiency. Among these latter patients, women (OR 1.45 [95%CI 1.33-1.57]), adults over 80 years of age (OR 2.63 [95%CI 2.38-2.91]), people living in nursing homes (OR 2.88 [95%CI 2.95-3.45]), and patients with walking dependence (OR 3.45 [95%CI 2.85-4.26]) appeared in higher proportion. After adjusting for confounding factors, a higher proportion of subjects with SARS-CoV-2 plus vitamin D deficiency required hospitalisation (OR 1.38 [95%CI 1.26-1.51]), and had a longer mean hospital stay (3.94 compared to 2.19 days in those with normal levels; P = 0.02). CONCLUSION: A low serum 25(OH) vitamin D concentration in patients with SARS-CoV-2 infection is significantly associated with a greater risk of hospitalisation and a longer hospital stay. Among such patients, higher proportions of institutionalised and dependent people over 80 years of age were detected.

Handgrip strength predicts 1-year functional recovery and mortality in hip fracture patients.

OBJECTIVES: Muscle strength is a possible predictor of adverse events. It could have prognostic value in patients with hip fracture (HF). The aim of this study was to determine if handgrip strength is associated with functional impairment, readmissions, and mortality at one year in elderly patients with HF. DESIGN: A prospective observational study was carried out. It included a cohort of patients aged 65 years or older with a diagnosis of fragility HF, consecutively from January 2013 to February 2014 and seen in follow-up at one year. Statistical analysis was performed using SPSS v21 software. MAIN OUTCOME MEASURES: Five hundred and nine patients with a mean age of 85.4 ± 0.3 years were included, of whom 403 (79.2 %) were women. Clinical and functional outcomes, laboratory parameters and anthropometric measurements were collected. RESULTS: Of the total sample, 339 (66.6 %) had reduced handgrip strength, and these patients were older, more frequently institutionalized, had poorer functional and cognitive status, higher comorbidity, higher surgical risk, lower body mass index and a greater intra-hospital mortality (all p < 0.01). At one year, patients with lower handgrip strength had a major change in their ability to walk (32.7 % vs. 10.9 %, p < 0.001) and a higher mortality rate (30.4 % vs. 8.8 %, p < 0.001). However, in patients over 91 years of age, there was no association between lower handgrip strength and change in ability to walk. There were no differences in the number of readmissions. CONCLUSION: Low handgrip strength in elderly patients with HF predicts greater functional disability and higher long-term mortality.

Impacto de la hospitalización en pacientes centenarios ingresados por enfermedad aguda. Descripción de una serie de 165 casos y comparación con la literatura / Impact of hospital admission on centenarians admitted due to an acute illness. A description of a series of 165 cases and comparison with the literature

Introducción: El envejecimiento de la población está suponiendo un aumento de pacientes centenarios, cuyas características podrían diferenciarse de las de los pacientes de menor edad. Este estudio se realizó para conocer el impacto de la hospitalización en los pacientes de 100 o más años ingresados por enfermedad aguda. Material y métodos: Se realizó un estudio observacional retrospectivo que incluyó a los pacientes con edad ≥ 100 años atendidos por el Servicio de Geriatría (SG) de un hospital universitario de tercer nivel desde 1995 hasta 2016. Se consultaron las bases de datos clínico-administrativas del SG, que incluían datos demográficos, clínicos, funcionales, cognitivos y administrativos. Se incluyó a pacientes atendidos en la Unidad Geriátrica de Agudos (UGA), en la Unidad de Ortogeriatría y como Interconsultas. Resultados: Se estudió a 165 pacientes, de 101,6 +/- 1,7 años de edad media +/- desviación estándar (rango 100-109), de los que 140 (85%) fueron mujeres. La estancia media fue de 10,3 +/- 7,4 días. El motivo de ingreso más frecuente en la UGA fueron las infecciones respiratorias (41%). La mortalidad global fue del 16%, pero en la UGA aumentó al 31%. La incapacidad funcional moderada-grave aumentó del 51% basal al 96% al alta y la incapacidad para la deambulación aumentó del 52% basal al 99% al alta. El porcentaje de pacientes residentes en domicilio disminuyó del 71 al 29% al alta. Conclusiones: En los pacientes centenarios, la hospitalización provoca una tasa elevada de mortalidad, un deterioro importante en su situación funcional y una reducción de la probabilidad de volver a su domicilio previo

Introduction: The number of centenarians is increasing with the aging of the Spanish population. This age group might present different clinical features from younger groups. This study was carried out to determine the impact hospital admission on centenarians with an acute disease. Materials and methods: A retrospective observational study was conducted that included patients ≥100 years-old admitted from 1995 to 2016 to a third level university hospital and attended by the Geriatrics department in the acute ward, the Orthogeriatric ward, and by request. An analysis was made using the clinical-administrative databases containing information about the demographics, clinical, functional and cognitive features, length of hospital length, as well as discharge destination. Results: The study included 165 patients with a mean age of 101.6 +/- 1.7 (range 100-109) years, of whom 140 (85%) were female. The mean hospital stay was 10.3 +/- 7.4 days. Respiratory infections (41%) were the most common cause of admission to the Acute Geriatric Unit (AGU). The overall in-hospital mortality was 16%, but mortality in AGU reached up to 31%. There was an increase on moderate-severe functional disability (51% to 96%), and on the inability to walk independently (52% to 99%) from baseline to admission. There was a reduction in people living in their own home from 71% prior to admission to 29% at hospital discharge. Conclusions: Centenarians who required hospital admission showed a high rate of mortality, a significant deterioration in their functional capacity, and a decrease in their chances of going back to their own home at discharge

[Impact of hospital admission on centenarians admitted due to an acute illness. A description of a series of 165 cases and comparison with the literature]. / Impacto de la hospitalización en pacientes centenarios ingresados por enfermedad aguda. Descripción de una serie de 165 casos y comparación con la literatura.

INTRODUCTION: The number of centenarians is increasing with the aging of the Spanish population. This age group might present different clinical features from younger groups. This study was carried out to determine the impact hospital admission on centenarians with an acute disease. MATERIALS AND METHODS: A retrospective observational study was conducted that included patients ≥100 years-old admitted from 1995 to 2016 to a third level university hospital and attended by the Geriatrics department in the acute ward, the Orthogeriatric ward, and by request. An analysis was made using the clinical-administrative databases containing information about the demographics, clinical, functional and cognitive features, length of hospital length, as well as discharge destination. RESULTS: The study included 165 patients with a mean age of 101.6 ± 1.7 (range 100-109) years, of whom 140 (85%) were female. The mean hospital stay was 10.3 ± 7.4 days. Respiratory infections (41%) were the most common cause of admission to the Acute Geriatric Unit (AGU). The overall in-hospital mortality was 16%, but mortality in AGU reached up to 31%. There was an increase on moderate-severe functional disability (51% to 96%), and on the inability to walk independently (52% to 99%) from baseline to admission. There was a reduction in people living in their own home from 71% prior to admission to 29% at hospital discharge. CONCLUSIONS: Centenarians who required hospital admission showed a high rate of mortality, a significant deterioration in their functional capacity, and a decrease in their chances of going back to their own home at discharge.