Prognostic Factors of COVID-19 Infection in Older Patients

Abstract

Introduction: COVID-19 can cause acute respiratory failure, metabolic acidosis, coagulopathy, septic shock, and death in older adults. The timely identification of at-risk patients will facilitate early intensive care intervention. Therefore, this study aimed to investigate the prognostic factors of COVID-19 in geriatric patients, a group shown to have higher mortality risk. Materials and Methods: A total of 61 patients over 65 years of age with presumed COVID-19 were included in the study. Patients' demographic characteristics, chest computed tomography findings at admission, biomarkers such as neutrophil/lymphocyte ratio (NLR), hemoglobin (g/dL), platelet count (109/L), alanine aminotransferase (ALT) (U/L), aspartate aminotransferase (AST) (U/L), total bilirubin (mg/dL), direct bilirubin (mg/dL), lactate dehydrogenase (LDH) (U/L), creatine kinase (CK) (U/L), blood urea nitrogen (BUN) (mg/dL), creatinine (mg/dL), albumin (mg/dL), D-dimer (ng/mL), ferritin (ng/mL), troponin (ng/mL), C-reactive protein (CRP) (mg/L), and procalcitonin (PCT) (ng/mL), complications during follow-up, and treatments received were recorded retrospectively from patient files and electronic records. Results: Mean age was 71.13 +/- 7.68 years, and 32 (52.5%) of the patients were males. During hospitalization, 18 patients (29.5%) were admitted to the intensive care unit and 10 (16.4%) died. Non-surviving patients were significantly older. Mean admitting NLR, LDH, CK, BUN, creatinine, troponin, D-dimer, CRP, and procalcitonin values were higher and mean albumin level was lower among the non-surviving patients. A Cox regression model based on variables associated with significantly prolonged hospital length of stay showed that highest NLR during follow-up was an independent risk factor for mortality and increased the risk of death by 10.67 times (95% Confidence Interval: 1.183-96.309) (p= 0.035). Conclusion: Highest NLR was found to be an independent risk factor for mortality and was associated with a 10-fold higher risk of death. Close monitoring and comprehensive treatment are required to reduce mortality in these patients.