Should COVID-19 patients \u3e75 years be Ventilated? An Outcome Study

Abstract

Background: Elderly patients with COVID-19 disease are at increased risk for adverse outcomes. Current data regarding disease characteristics and outcomes in this population are limited. Aim: To delineate the adverse factors associated with outcomes of COVID-19 patients ≥ 75 years of age. Design: Retrospective cohort study. Methods: Patients were classified into mild/moderate, severe/very severe and critical disease (intubated) based on oxygen requirements. The primary outcome was in-hospital mortality. Results: A total of 355 patients aged ≥ 75 years hospitalized with COVID-19 between 19 March and 25 April 2020 were included.Mean age was 84.3 years. One-third of the patients developed critical disease. Mean length of stay was 7.10 days. Vasopressors were required in 27%, with the highest frequency in the critical disease group (74.1%). Overall mortality was 57.2%, with a significant difference between severity groups (mild/moderate disease: 17.4%, severe/very severe disease: 71.3%, critical disease: 94.9%, P \u3c 0.001).Increased age, dementia, and severe/very severe and critical disease groups were in- dependently associated with increased odds for mortality while diarrhea was associated with decreased odds for mortality (OR: 0.12, 95% CI: 0.02–0.60, P \u3c 0.05). None of the cardiovascular comorbidities were significantly associated with mortality. Conclusion: Age and dementia are associated with increased odds for mortality in patients ≥ 75 years of age hospitalized with COVID-19. Those who require intubation have the greatest odds for mortality. Diarrhea as a presenting symptom was associated with lower odds for mortality