COVID in oldest old: What we learnt in a tertiary care hospital emergency

Background

COVID-19 created extreme havoc among the elderly and the oldest-old bore the maximum brunt during triaging. With COVID cases again on the raise, this retrospective analysis gives an insight of the clinical spectrum and mortality in COVID-19 infected elderly patients admitted to a tertiary care teaching hospital in southern India during the first and the second waves of COVID.

Methods

The electronic database search for the patients’ records was performed using hospital HIS platform. The variables included patients’ demography, presenting complaints, comorbidities, d-dimer value, treatment received and the length of stay till discharge or death. The data was presented as n (%) and the odds ratio at a 95 % confidence interval was used to identify the predictors.

Results

A total of 1378 COVID-positive elderly patient records were analysed. Elderly aged 60–74 years were considered as young-old, 75–84 years middle old and above 85 years as oldest old. 75.3 % elderly had comorbidities [p < 0.001]. There were 225(16 %) mortalities 31.9 % in oldest-old. Increasing age (OR 1.027, p = 0.022*) male gender (OR 1.598, p = 0.016*), low SpO2 on admission (OR 0.922, p < 0.001*), and duration of hospital stay (OR 0.907, p < 0.001*) were significant predictors of the event.

Conclusion

Maximum mortality was seen in the oldest old who had fewer days of hospitalization and d-dimer had no prognostication in the oldest old.