Background The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID-19 remain unclear. Objective To determine the association of chronic diseases, chest computed tomography (CT), and laboratory tests with severe respiratory failure and mortality in older adults hospitalized with COVID-19. Method This was a prospective cohort with 201 hospitalized older adults with COVID-19. Chronic diseases, chest CT, laboratory tests, and other data were collected within the first 48 h of hospitalization. Outcomes were progression to severe respiratory failure with the need of mechanical ventilation (SRF/MV) and death. Results The mean age was 72.7 ± 9.2 years, and 63.2% were men. SRF/MV occurred in 16.9% ( p < 0.001), and death occurred in 8%. In the adjusted regression analyses, lung involvement over 50% [odds ratio (OR): 3.09 (1.03–9.28; 0.043)], C-reactive protein (CRP) > 80 ng/mL [OR: 2.97 (0.99–8.93; 0.052)], Vitamin D < 40 ng/mL [OR: 6.41 (1.21–33.88; 0.029)], and hemoglobin < 12 g/mL [OR: 3.32 (1.20–9.20; 0.020)] were independent predictors for SFR/MV, while chronic atrial fibrillation [OR: 26.72 (3.87–184.11; 0.001)], cancer history [OR:8.32 (1.28–53.91; 0.026)] and IL-6 > 40 pg/mL [OR:10.01 (1.66–60.13; 0.012)] were independent predictors of death. Conclusion In hospitalized older adults with COVID-19, tomographic pulmonary involvement > 50%, anemia, vitamin D below 40 ng/mL, and CRP above 80 mg/L were independent risk factors for progression to SRF/MV. The presence of chronic atrial fibrillation, previous cancer, IL-6 > 40 pg/mL, and anemia were independent predictors of death.
【저자키워드】 COVID-19, Anemia, Respiratory failure, Mortality, Vitamin D, elderly, 【초록키워드】 Diseases, Hospitalized, mechanical ventilation, Hospitalization, lung involvement, Cancer, severe respiratory failure, C-reactive protein, CRP, Laboratory tests, progression, risk factor, Chest computed tomography, Atrial fibrillation, Chest CT, death, age, Vitamin, hemoglobin, prospective cohort, association, Laboratory test, chronic, Chronic diseases, Regression analyses, Older, pulmonary involvement, independent risk factor, men, objective, Result, collected, occurred, adjusted, determine, adults hospitalized, independent predictor, with COVID-19, 【제목키워드】 Diseases, severe respiratory failure, prospective cohort study, Chest computed tomography, death, predictor, Laboratory test, chronic, patients hospitalized,