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Clinical, biological and radiological features, 4-week outcomes and prognostic factors in COVID-19 elderly inpatients

Authors :
Olivier Paccoud
Alexandre Bleibtreu
Nagisa Godefroy
Y. Wakim
S. Boussouar
Romain Palich
M. Levy-Soussan
Cathia Soulié
Oula Itani
Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP)
Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Laboratoire d'Imagerie Biomédicale (LIB)
Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)
Service d'Oncologie médicale [CHU Pitié-Salpêtrière]
CHU Pitié-Salpêtrière [AP-HP]
Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Gestionnaire, HAL Sorbonne Université 5
Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Source :
Infectious Diseases Now, Infectious Diseases Now, Elsevier, 2021, ⟨10.1016/j.idnow.2020.12.004⟩, Infectious Diseases Now, 2021, ⟨10.1016/j.idnow.2020.12.004⟩
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

International audience; ObjectiveTo describe clinical, biological, radiological presentation and W4 status in COVID-19 elderly patients.Patients and methodsAll patients ≥ 70 years with confirmed SARS-CoV-2 infection and hospitalized in the Infectious Diseases department of the Pitié-Salpêtrière hospital, Paris, France, from March 1st to April 15th 2020 were included. The primary outcome was death four weeks after hospital admission. Data on demographics, clinical features, laboratory tests, CT-scan findings, therapeutic management and complications were collected.ResultsAll in all, 100 patients were analyzed, including 49 patients ≥ 80 years. Seventy percent had ≥2 comorbidities. Respiratory features were often severe as 48% needed oxygen support upon admission. Twenty-eight out of 43 patients (65%) with a CT-scan had mild to severe parenchymal impairment, and 38/43 (88%) had bilateral impairment. Thirty-two patients presented respiratory distress requiring oxygen support ≥ 6 liters/minute. Twenty-four deaths occurred, including 21 during hospitalization in our unit, 2 among the 8 patients transferred to ICU, and one at home after discharge from hospital, leading to a global mortality rate of 24% at W4. Age, acute renal failure and respiratory distress were associated with mortality at W4.ConclusionA substantial proportion of elderly COVID-19 patients with several comorbidities and severe clinical features survived, a finding that could provide arguments against transferring the most fragile patients to ICU.

Details

ISSN :
26669919
Volume :
51
Database :
OpenAIRE
Journal :
Infectious Diseases Now
Accession number :
edsair.doi.dedup.....13bd05399e2f34fa0eb58487d17d9e5e