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COVID-19 in Older Adults: A Series of 76 Patients Aged 85?Years and Older with COVID-19.

ABSTRACT: BACKGROUND:Clinical presentation and risk factors of death in COVID-19 in oldest adults have not been well characterized. OBJECTIVES:To describe clinical features and outcome of COVID-19 in patients older than 85?years and study risk factors for mortality. DESIGN:Prospective cohort. PARTICIPANTS AND SETTING:Patients aged 85?years and older, admitted in noncritical care units at the University Hospital Lariboisière Fernand-Widal (Paris, France) for confirmed severe acute respiratory syndrome coronavirus 2 infection were included and followed up for 21?days. MEASUREMENTS:Clinical and laboratory findings were collected. Cox survival analysis was performed to explore factors associated with death. RESULTS:From March 14 to April 11, 2020, 76 patients (median age = 90 (86-92) years; women = 55.3%) were admitted for confirmed COVID-19. Of the patients, 64.5% presented with three or more comorbidities. Most common symptoms were asthenia (76.3%), fever (75.0%) and confusion and delirium (71.1%). An initial fall was reported in 25.0% of cases, and digestive symptoms were reported in 22.4% of cases. COVID-19 was severe in 51.3% of cases, moderate in 32.9%, and mild in 15.8%. Complications included acute respiratory syndrome (28.9%), cardiac decompensation (14.5%), and hypotensive shock (9.0%). Fatality at 21?days was 28.9%, after a median course of disease of 13 (8-17) days. Males were overrepresented in nonsurvivors (68.2%). In survivors, median length of stay was 12 (9-19.5) days. Independent predictive factors of death were C-reactive protein level at admission and lymphocyte count at nadir. CONCLUSION:Specific clinical features, multiorgan injury, and high case fatality rate are observed in older adults with COVID-19. However, rapid diagnosis, appropriate care, and monitoring seem to improve prognosis.

SUBMITTER: Vrillon A

PROVIDER: S-EPMC7675559 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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COVID-19 in Older Adults: A Series of 76 Patients Aged 85 Years and Older with COVID-19.

Vrillon Agathe A Hourregue Claire C Azuar Julien J Grosset Lina L Boutelier Ada A Tan Sophie S Roger Michael M Mourman Vianney V Mouly Stéphane S Sène Damien D François Véronique V Dumurgier Julien J Paquet Claire C

Journal of the American Geriatrics Society 20201028 12

<h4>Background</h4>Clinical presentation and risk factors of death in COVID-19 in oldest adults have not been well characterized.<h4>Objectives</h4>To describe clinical features and outcome of COVID-19 in patients older than 85 years and study risk factors for mortality.<h4>Design</h4>Prospective cohort.<h4>Participants and setting</h4>Patients aged 85 years and older, admitted in noncritical care units at the University Hospital Lariboisière Fernand-Widal (Paris, France) for confirmed severe ac ...[more]

PMID: 33045106

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Project description:BackgroundOlder adults are given high priority for coronavirus disease 2019 (COVID-19) vaccination; however, little is known about the safety of vaccines. This study was conducted to examine the safety of the COVID-19 vaccine for people who were ≥ 75 years of age, specifically those who first took two doses of the vaccine at the COVID-19 central vaccination center in South Korea.MethodsSafety monitoring after the BNT162b2 vaccine was conducted in three ways for older adults who received the first dose of the vaccine at our center between April 5 and April 23, 2021. For immediate adverse reactions, every person who was vaccinated was observed for 15-30 minutes after injection at the center. For active surveillance, a telephone interview was conducted for stratified randomly sampled people after 7 days of each vaccination to enquire regarding types of adverse reactions they experienced, and its severity and duration. For passive surveillance, reported adverse event data were collected from the COVID-19 vaccine adverse event following immunization (AEFI) surveillance system-run by the Korea Disease Control and Prevention Agency (KDCA). The data were then reviewed.ResultsIn total, 2,123 older adults received at least one vaccine dose during the study period. The frequency of acute adverse reactions that developed during the observed 15-30 minutes after injection was 8.5 cases per 1,000 doses. None of the reactions was assessed as acute allergic reactions to the vaccine and no cases required special treatment or drug administration. Overall, 638 people were followed up at least once by telephone interview 7 days post vaccination. The overall response rate was 82.3%. The rates of local reactions were 50.3% after the first dose and 45.2% after the second dose, and the rates of systemic reactions were 15.2% and 26.0%, respectively. During the study period, 23 medically attended adverse events (5.4 cases per 1,000 administered doses) were reported to the KDCA AEFI surveillance system. The most common symptoms of medically attended cases were nonspecific general weakness (26%) and dizziness (26%), followed by muscle pain (22%), headache (13%), fever (13%), and skin rash or urticaria (13%). Among them, there were five serious adverse events reported, which required hospitalization, including one death. However, most of them were not related to the vaccines.ConclusionBNT162b2 vaccination was tolerable among adults who were ≥ 75 years of age.

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COVID-19 in Older Adults: A Series of 76 Patients Aged 85?Years and Older with COVID-19.

Publications

COVID-19 in Older Adults: A Series of 76 Patients Aged 85 Years and Older with COVID-19.

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