Abstract
BackgroundThe actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in Rome.MethodsThis is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65–80 years old; Very Elderly > 80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding.The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction.The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH) s and clinical outcomes.ResultsWe found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease.ConclusionWe demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.
Highlights
The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people
In this study, we focused our attention on very elderly population (> 80 years of age) [11, 12] that referred to our University Hospital during the actual SARS-CoV-2 outbreak and we have analyzed the differences between elderly people and very elderly ones
Forty-one patients with ages ranging from 65 to years were included in Elderly Group, the remaining forty patients with ages > years were included in group named Very Elderly
Summary
The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. Since the beginning of the actual SARS-CoV-2 outbreak it was evident that older people, compared to younger ones, were at higher risk to get the infection and to develop a more severe disease with unfavorable prognosis. The mean age of patients that died was 80 years, at least 20 years higher than that registered in infected people. The majority of those who are infected, that have a self-limiting infection and do recover are, younger. Those that suffer a more severe disease, that require intensive care unit admission and eventually pass away are older [2, 3]
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