Study of Clinical Profile & Outcome in Elderly Patients with COVID-19
Manjiri Naik
Department of Medicine, MGM Medical College and Hospital, Aurangabad, India.
Rajiv Naik
Department of Medicine, MGM Medical College and Hospital, Aurangabad, India.
Awani Paithankar *
Department of Medicine, MGM Medical College and Hospital, Aurangabad, India.
Siddhiraj Paramshetti
Department of Medicine, MGM Medical College and Hospital, Aurangabad, India.
Shubham Patel
Department of Medicine, MGM Medical College and Hospital, Aurangabad, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Novel beta coronavirus (SARS-CoV-2) has caused widespread transmission of coronavirus illness (COVID-19) in India from March 2020. In comparison to younger adults, older people and those with numerous co-morbidities are known to be more severely affected by seasonal flu and to have a higher mortality rate. The mortality rate increases significantly in the age groups over 60 years old with SARS-CoV-2 infection. With this objective present study was undertaken to study clinical profile and outcome in elderly COVID 19 patients
Materials and Methods: Data of 100 elderly patients aged 60 years and older with COVID-19 were obtained from hospital record section. It consisted of clinical characteristics, respiratory manifestations, laboratory parameters and radiological findings. COVID-19 confirmation was based on reverse transcription polymerase chain reaction (RT-PCR). 100 patients were divided into two groups based on outcome as Group A (Survivors) and Group B (Non-Survivors). They included 66 males and 34 females.
Observation and Results: Respiratory rate more than 30 was mainly present in group B patients (19%) compared to group A. In majority patients i.e. 79 (79%) SpO2 was between 80 to 95 range and majority i.e. 35 (35%) given Oxygen via nasal prongs. Haemoglobin <12 and Leucocytes ≤ 11000 was found in maximum patients. CRP, D dimer and random blood sugar showed statistically significant difference between two groups (P<0.0001). Ground glass opacities was main pattern found in 46 (46%), Bilateral Consolidation found in 41 (41%) and Unilateral Consolidation in 13 (13%). Results showed no statistically significant difference amongst two groups (P=0.725)
Discussion: A progressive and relatively linear increase in nasal cavity volume with increasing age along with an age-dependent decrease of nasal resistance are possible determinants for a higher prevalence of COVID in the elderly population
Conclusion: An individualized approach should be offered to older adults targeting the beneficial and negative effects of therapeutic approach
Keywords: COVID-19, elderly patients, SARS-CoV
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References
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al.; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–33.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
WHO. Coronavirus disease (COVID-19) Pandemic.
Available:https://www.who.int/ emergencies/diseases/novel-coronavirus-2019.
WHO. General’s opening remarks at the Mission briefing on COVID-19 – 12 March; 2020. Available:https://www.who.int/dg/speeches/detail/who-director-general-sopening-remarks-at-the-mission-briefingon- covid-19-12-march-2020
Dawei W, Bo H, Chang H, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–69.
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–81.
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(10229):1054–62.
Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, et al. Characteristics of COVID-19 infection in Beijing. J Infect. 2020;80(4):401–6.
WHO. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected: interim guidance. Jan 28, 2020. Geneva: World Health Organization; 2020.
Chinese National Health Committee. The diagnostic and treatment guideline for novel coronavirus pneumonia (version seven).
Available:http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5 912eb1989.shtml
Wu J, Liu J, Zhao X, Liu C, Wang W, Wang D, et al. Clinical characteristics of imported cases of COVID-19 in Jiangsu Province: a multicenter descriptive study. Clin Infect Dis; 2020.
DOI: 10.1093/cid/ciaa199
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(10223):507–13.
Yang R, Li X, Liu H, Zhen Y, Zhang X, Xiong Q, Luo Y, Gao C, Zeng W. Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19. Radiol Cardiothorac Imaging. 2020;2(2):e200047.
DOI: 10.1148/ryct.2020200047. PMID: 33778560; PMCID: PMC7233443.
Available:https://www.nmcnagpur.gov.in/assets/250/2021/04/mediafiles/COVID_latest_guidelines.pdf [Last accessed on 24/10/2022]
Azwar MK, Setiati S, Rizka A, Fitriana I, Saldi SR, Safitri ED. Clinical profile of elderly patients with COVID-19 hospitalised in Indonesia’s National General Hospital. Acta Medica Indonesiana. 2020;52(3):199.
Ting Guo, Qinxue Shen, Wei Guo, Wenlong He, Jinhua Li, Yi Zhang, Yunnian Wang, Zhiguo Zhou, Dingding Deng, Xiaoli Ouyang, Zhi Xiang, Minyan Jiang, Minyong Liang, Peng Huang, Zaimei Peng, Xudong Xiang, Wenlong Liu, Hong Luo, Ping Chen, Hong Peng. Clinical Characteristics of elderly patients with COVID-19 in hunan province, China: A multicenter, retrospective study. Gerontology. 2020;66: 467–475
Sunny Singhal, Pramod Kumar, Sumitabh Singh, Srishti Saha, Aparajit Ballav Dey. Clinical features and outcomes of COVID-19 in older adults: A systematic review and meta-analysis. BMC Geriatrics. 2021;21:321.
Svartengren M, Falk R, Philipson K. Long-term clearance from small airways decreases with age. Eur Respir J. 2005;26:609–615.
Levitzky MG. Efects of aging on the respiratory system. Physiologist. 1984;27:102–107.
Martin SE, Mathur R, Marshall et al. The efect of age, sex, obesity and posture on upper airway size. Eur Respir J. 1997;10:2087–2090.