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Research article
Michela D'Ascanio
Universita degli Studi di Roma La Sapienza
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2141-7409
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The 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 evolution of the disease in this group of patients, admitted to our Hospital in Rome
Methods: This 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 (G1 65-80 years old; G2 >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. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariable Cox proportional hazard regression and ordinal logistic regression were performed to estimate associations between age, comorbidities and provenance from residential care homes and clinical outcomes.
Results: We found that G2 patients had an increased mortaliy rate, also due to (the frequent prevalence of) multiple comorbidities. Moreover we found that patients coming from long-stay residential care homes appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease.
Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes; moreover, to establish a correct risk stratification, comorbidities and information about provenience from residential care homes should be considered.
Keywords
Elderly, comorbidities, COVID 19, residential care homes
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CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Editorial decision: Accept
On 05 Jan, 2021
Editor assigned
On 27 Dec, 2020
Editor invited
On 27 Dec, 2020
Submission checks complete
On 20 Jul, 2020
No comments provided
Reviewer #2 agreed
On 13 Dec, 2020
Reviewers invited
Invitations sent on 10 Dec, 2020
Reviewer #1 agreed
On 10 Dec, 2020
Review #1 received
Received 10 Dec, 2020
Editor assigned
On 09 Dec, 2020
Editor invited
On 09 Dec, 2020
Submission checks complete
On 20 Jul, 2020
Version 1
Posted 24 Jul, 2020
No comments provided
Editorial decision: Major revision
On 01 Nov, 2020
Review #2 received
Received 31 Oct, 2020
Review #1 received
Received 14 Sep, 2020
Reviewer #2 agreed
On 04 Sep, 2020
Reviewer #1 agreed
On 31 Aug, 2020
Reviewers invited
Invitations sent on 27 Jul, 2020
First submitted
On 16 Jul, 2020
Editor assigned
On 16 Jul, 2020
Submission checks complete
On 15 Jul, 2020
Editor invited
On 15 Jul, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
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A new preprint design is coming!
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See the published version of this preprint at BMC Geriatrics.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Michela D'Ascanio
Universita degli Studi di Roma La Sapienza
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2141-7409
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Editorial decision: Accept
On 05 Jan, 2021
Editor assigned
On 27 Dec, 2020
Editor invited
On 27 Dec, 2020
Submission checks complete
On 20 Jul, 2020
No comments provided
Reviewer #2 agreed
On 13 Dec, 2020
Reviewers invited
Invitations sent on 10 Dec, 2020
Reviewer #1 agreed
On 10 Dec, 2020
Review #1 received
Received 10 Dec, 2020
Editor assigned
On 09 Dec, 2020
Editor invited
On 09 Dec, 2020
Submission checks complete
On 20 Jul, 2020
Version 1
Posted 24 Jul, 2020
No comments provided
Editorial decision: Major revision
On 01 Nov, 2020
Review #2 received
Received 31 Oct, 2020
Review #1 received
Received 14 Sep, 2020
Reviewer #2 agreed
On 04 Sep, 2020
Reviewer #1 agreed
On 31 Aug, 2020
Reviewers invited
Invitations sent on 27 Jul, 2020
First submitted
On 16 Jul, 2020
Editor assigned
On 16 Jul, 2020
Submission checks complete
On 15 Jul, 2020
Editor invited
On 15 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background: The 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 evolution of the disease in this group of patients, admitted to our Hospital in Rome
Methods: This 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 (G1 65-80 years old; G2 >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. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariable Cox proportional hazard regression and ordinal logistic regression were performed to estimate associations between age, comorbidities and provenance from residential care homes and clinical outcomes.
Results: We found that G2 patients had an increased mortaliy rate, also due to (the frequent prevalence of) multiple comorbidities. Moreover we found that patients coming from long-stay residential care homes appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease.
Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes; moreover, to establish a correct risk stratification, comorbidities and information about provenience from residential care homes should be considered.
Figure 1
Figure 2
The full text of this article is available to read as a PDF.
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