Comparison of Clinical Manifestation and Mortality-Related Risk Factors Between Elderly and Middle-Aged COVID-19 Patients
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Abstract
Given that the risk factors associated with mortality and morbidity of Coronavirus Disease (COVID-19) vary among age groups, this study aimed to describe the differences in clinical characteristics and mortality-related risk factors between elderly and middle-aged COVID-19 patients. A total of 1061 patients were included in this retrospective cohort study. Patients’ radiology reports and laboratory data were extracted from the available data on the Hospital Information System (HIS), and clinical findings were added in special forms. We followed up cases until death or discharge to evaluate patients’ outcomes. Chronic obstructive pulmonary disease (COPD) (95% CI, HR 2.73 (0.97-6.62)), need for antibiotics (95% CI, HR 2.26 (1.20-4.26)), and diabetes (95% CI, HR 1.77 (0.97-3.24)) were associated with a higher risk of mortality among middle-aged COVID-19 patients; while, age (95% CI, HR 1.04 (1.01-1.06)) was associated with increased mortality rate in elderly patients. We found that the need for antibiotics was associated with a worse outcome of COVID-19. Additionally, we described the differences between elderly and middle-aged COVID-19 patients regarding their comorbidities, laboratory findings, and clinical manifestation.
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26. Jalili E, Keramat F, Bashirian S, Khazaei S, Talebi- Ghane E, Karami M, et al. Demographic and clinical features association with mortality in patients with COVID-19: A cross-sectional study in the west of Iran. Acta Med Iran 2021;59:587-94.
2. Khan ZH, Samadi S, Makarem J, Mireskandari SM. Tests with proven value in diagnosis of COVID-19. Iranian J Microbiol 2020;12:261-2.
3. Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. Methods Mol Biol 2015:1282:1-23.
4. Horita N, Fukumoto T. Global case fatality rate from COVID-19 has decreased by 96.8% during 2.5 years of the pandemic. J Med Virol 2023;95:e28231.
5. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.
6. Novel CPERE. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi 2020;41:145-51.
7. Imam Z, Odish F, Gill I, O'Connor D, Armstrong J, Vanood A, et al. Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID‐19 patients in Michigan, United States. J Intern Med 2020;288:469-76.
8. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
9. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.
10. De Vito A, Geremia N, Fiore V, Princic E, Babudieri S, Madeddu G. Clinical features, laboratory findings and predictors of death in hospitalized patients with COVID-19 in Sardinia, Italy. Eur Rev Med Pharmacol Sci 2020;24:7861-8.
11. Paranga TG, Pavel-Tanasa M, Constantinescu D, Plesca CE, Petrovici C, Miftode IL, et al. Comparison of C-reactive protein with distinct hyperinflammatory biomarkers in association with COVID-19 severity, mortality and SARS-CoV-2 variants. Front Immunol 2023;14:1213246.
12. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its Impact on Patients with COVID-19. SN Compr Clin Med 2020;2:1069-76.
13. Iaccarino G, Grassi G, Borghi C, Ferri C, Salvetti M, Volpe M, et al. Age and multimorbidity predict death among COVID-19 patients: results of the SARS-RAS study of the Italian Society of Hypertension. Hypertension 2020;76:366-72.
14. Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY) 2020;12:12493-503.
15. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.
16. Dorshkind K, Swain S. Age-associated declines in immune system development and function: causes, consequences, and reversal. Curr Opin Immunol 2009;21:404-7.
17. Fernández-Ruiz I. Immune system and cardiovascular disease. Nat Rev Cardiol 2016;13:503.
18. Ragab D, Salah Eldin H, Taeimah M, Khattab R, Salem R. The COVID-19 cytokine storm; what we know so far. Front Immunol 2020;11:1446.
19. Langford BJ, So M, Raybardhan S, Leung V, Westwood D, MacFadden DR, et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect 2020;26:1622-9.
20. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020;46:846-8.
21. Zhu W, Xie K, Lu H, Xu L, Zhou S, Fang S. Initial clinical features of suspected coronavirus disease 2019 in two emergency departments outside of Hubei, China. J Med Virol 2020;92:1525-32.
22. Kakodkar P, Kaka N, Baig M. A comprehensive literature review on the clinical presentation, and management of the pandemic coronavirus disease 2019 (COVID-19). Cureus 2020;12:e7560.
23. Karvandian K, Tadbir Vajargah K, Beigi S, Mohammadzadeh N, Ashouri M, Samadi S, et al. The Association of Seasonal Variations and COVID-19 Clinical Features: A Comparative Study on the Fourth and Fifth Waves. Int J Clin Pract 2022;2022:8347103.
24. Martín-Sánchez FJ, Del Toro E, Cardassay E, Carbó AV, Cuesta F, Vigara M, et al. Clinical presentation and outcome across age categories among patients with COVID-19 admitted to a Spanish Emergency Department. Eur Geriatr Med 2020;11:829-41.
25. Huang I, Pranata R, Lim MA, Oehadian A, Alisjahbana B. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Ther Adv Respir Dis 2020:14:1753466620937175.
26. Jalili E, Keramat F, Bashirian S, Khazaei S, Talebi- Ghane E, Karami M, et al. Demographic and clinical features association with mortality in patients with COVID-19: A cross-sectional study in the west of Iran. Acta Med Iran 2021;59:587-94.
| Files | ||
| Issue | Vol 61 No 9 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v61i9.15282 | |
| Keywords | ||
| COVID-19 Aged Middle-aged Mortality Survivors | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Akrami M, Hosamirudsari H, Faraji N, Nataj Majd M. Comparison of Clinical Manifestation and Mortality-Related Risk Factors Between Elderly and Middle-Aged COVID-19 Patients. Acta Med Iran. 2024;61(9):519-525.
