Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study
Abstract 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 mortali...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-02-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-02776-3 |
| _version_ | 1818280224336379904 |
|---|---|
| author | Alberto Frisoli Junior Elaine Azevedo Angela Tavares Paes Eliene Lima João Carlos Campos Guerra Sheila Jean Mc Neill Ingham |
| author_facet | Alberto Frisoli Junior Elaine Azevedo Angela Tavares Paes Eliene Lima João Carlos Campos Guerra Sheila Jean Mc Neill Ingham |
| author_sort | Alberto Frisoli Junior |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-12T23:45:49Z |
| format | Article |
| id | doaj.art-2d776c4f4efd4bedb94b80c8bbc02b79 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T23:45:49Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-2d776c4f4efd4bedb94b80c8bbc02b792022-12-22T00:06:51ZengBMCBMC Geriatrics1471-23182022-02-0122111210.1186/s12877-022-02776-3Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort studyAlberto Frisoli Junior0Elaine Azevedo1Angela Tavares Paes2Eliene Lima3João Carlos Campos Guerra4Sheila Jean Mc Neill Ingham5Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, MorumbiHospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, MorumbiHospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, MorumbiElderly Vulnerability Disease Research Group Unit, Cardiology Division, Federal University of São PauloHospital Israelita Albert Einstein, Avenida Albert Einstein, 627. 1° Subsolo, Bloco B, MorumbiElderly Vulnerability Disease Research Group Unit, Cardiology Division, Federal University of São PauloAbstract 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.https://doi.org/10.1186/s12877-022-02776-3COVID-19Respiratory failureElderlyMortalityVitamin DAnemia |
| spellingShingle | Alberto Frisoli Junior Elaine Azevedo Angela Tavares Paes Eliene Lima João Carlos Campos Guerra Sheila Jean Mc Neill Ingham Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study BMC Geriatrics COVID-19 Respiratory failure Elderly Mortality Vitamin D Anemia |
| title | Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study |
| title_full | Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study |
| title_fullStr | Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study |
| title_full_unstemmed | Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study |
| title_short | Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study |
| title_sort | chronic diseases chest computed tomography and laboratory tests as predictors of severe respiratory failure and death in elderly brazilian patients hospitalized with covid 19 a prospective cohort study |
| topic | COVID-19 Respiratory failure Elderly Mortality Vitamin D Anemia |
| url | https://doi.org/10.1186/s12877-022-02776-3 |
| work_keys_str_mv | AT albertofrisolijunior chronicdiseaseschestcomputedtomographyandlaboratorytestsaspredictorsofsevererespiratoryfailureanddeathinelderlybrazilianpatientshospitalizedwithcovid19aprospectivecohortstudy AT elaineazevedo chronicdiseaseschestcomputedtomographyandlaboratorytestsaspredictorsofsevererespiratoryfailureanddeathinelderlybrazilianpatientshospitalizedwithcovid19aprospectivecohortstudy AT angelatavarespaes chronicdiseaseschestcomputedtomographyandlaboratorytestsaspredictorsofsevererespiratoryfailureanddeathinelderlybrazilianpatientshospitalizedwithcovid19aprospectivecohortstudy AT elienelima chronicdiseaseschestcomputedtomographyandlaboratorytestsaspredictorsofsevererespiratoryfailureanddeathinelderlybrazilianpatientshospitalizedwithcovid19aprospectivecohortstudy AT joaocarloscamposguerra chronicdiseaseschestcomputedtomographyandlaboratorytestsaspredictorsofsevererespiratoryfailureanddeathinelderlybrazilianpatientshospitalizedwithcovid19aprospectivecohortstudy AT sheilajeanmcneillingham chronicdiseaseschestcomputedtomographyandlaboratorytestsaspredictorsofsevererespiratoryfailureanddeathinelderlybrazilianpatientshospitalizedwithcovid19aprospectivecohortstudy |