Abstract in English, Spanish
Objective: Despite the impact of SARS-CoV-2 infection in geriatrics, data on nonagenarian patients is scarce. The aim of this study is to describe the clinical features of COVID19-diagnosed nonagenarians, as well as its clinical evolution and therapeutic response.
Methods: Retrospective observational study of nonagenarians, admitted for COVID-19. Sociodemographic and clinical variables were registered, including previous polypharmacy. Blood analysis data and COVID-19-specific treatment were registered.
Results: A total of 79 patients were included, with 50.6% (40 patients) of mortality. None of the comorbidities registered correlated with mortality, which was significantly higher among patients with moderate/complete functional dependence, compared to those mild-dependents/independents (59.5% vs 40.5%; p=0.015). Most prescribed drugs were hydroxychloroquine/chloroquine and azithromycin. Non-survivors presented higher counts of leukocytes and neutrophils, and higher lymphopenia.
Conclusions: Nonagenarians with functional dependence presented higher mortality, irrespective of comorbidities or treatment received. Implementing an integral geriatric evaluation would enhance the implementation of personalized therapeutic strategies for nonagenarians.
Introducción: A pesar del impacto del SARS-CoV-2 en geriatría, disponemos de escasa información en pacientes nonagenarios. Nuestro objetivo es describir características clínicas, respuesta al tratamiento y factores de riesgo de mortalidad en nonagenarios con COVID-19.
Material y métodos: Estudio retrospectivo observacional de pacientes nonagenarios hospitalizados por COVID-19. Se registraron variables sociodemográficas, clínicas y polifarmacia previa, parámetros analíticos y tratamiento específico.
Resultados: Se incluyeron 79 pacientes. No se relacionó con mortalidad ninguna de las comorbilidades. La mortalidad fue del 50,6%, siendo mayor en pacientes con dependencia funcional moderada/grave respecto aquéllos independientes/ dependientes leves (59,5% vs 40,5%; p=0,015). Los fármacos específicos más prescritos fueron hidroxicloroquina/cloroquina y azitromicina. Los pacientes fallecidos presentaron más leucocitos y neutrófilos, y mayor linfopenia.
Conclusión: En nuestra cohorte, el estado funcional es el principal factor de riesgo de mortalidad, independientemente de las comorbilidades y el tratamiento recibido. Implementar la valoración geriátrica integral permitiría individualizar las estrategias terapéuticas en nonagenarios.
Keywords: COVID-19; functional dependence; nonagenarians.
【저자키워드】 COVID-19, functional dependence, nonagenarians., 【초록키워드】 Treatment, Neutrophils, SARS-CoV-2, Chloroquine, Azithromycin, Mortality, Hydroxychloroquine, SARS-COV-2 infection, Comorbidities, Comorbidity, drug, observational study, Clinical features, lymphopenia, Geriatrics, implementation, Patient, patients, clinical feature, therapeutic strategy, leukocytes, Analysis, leukocyte, Non-survivors, clinical variables, Registered, material, clinical evolution, specific treatment, MOST, variable, hydroxychloroquine/chloroquine, Spanish, English, therapeutic response, ENhance, functional, correlated, significantly higher, clinical variable, Implementing, 【제목키워드】 Hospitalized, pharmacological,