Clinical Characteristics on Admission Predict In-Hospital Fatality in Old Patients with COVID-19

Background: COVID-19has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods: Consecutive 141 COVID-19 patients aged ≥75 years were enrolled. Clinical characteristics and laboratory findings on admission were obtained. The primary endpoint of study was in-hospital death. Logistic regression was used to identify risk factors. Findings: The median age was 81 years (84 female, 59·6%). 38 (27%) patients were classified as severe or critical cases. 18 (12.8%) patients died in hospital and the remaining 123 were discharged. CT scan identified ground-glass opacity lesions in all patients, 53 (37.6%) in ≥ 3 lung lobes. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low oxygen saturation (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (77.8% vs. 30.1%), high sensitivity troponin I (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (72.2% vs. 6.5%; all P<0.05). Male sex (odds ratio=13.1), body temperature >37.3°C (odds ratio =80.5), oxygen saturation ≤ 90% (odds ratio =70.1), and N-terminal pro-brain natriuretic peptide >1800ng/L (odds ratio =273.5) were independent risk factors of in-hospital death. Interpretations: In-hospital fatality among COVID-19 patients aged ≥75 years can be estimated by sex and on-admission measurements of body temperature, oxygen saturation, and N-terminal pro-brain natriuretic peptide. Funding Statement: This work was partially supported by the National Administration of Traditional Chinese Medicine (2020ZYLCYJ03-11). Declaration of Interests: None. Ethics Approval Statement: This study was approved by the Institutional Ethics Board of the First Hospital of Wuhan (No.202008). Oral consent was obtained from each patient to use his/her medical records for research purposes. The need to obtain written consent was waived by the Ethics Board for emerging infectious diseases.