Factors associated with adverse outcomes in hospitalized older adult patients with COVID-19

Abstract

Introduction: Older patients with COVID-19 (Coronavirus disease 2019) are at increased risk of adverse outcome. The aim of this study was to evaluate clinical and laboratory factors associated with prognosis in hospitalized patients aged ≥ 49 years. Materials and Methods: A retrospective study was conducted among 93 patients with confirmed COVID-19. Demographic data, symptoms at admission, laboratory parameters, serum amyloid A (SAA), and hospital outcome (improvement or severe outcome) were analyzed. The Mann–Whitney U test, Fisher’s exact test, and Receiver Operating Characteristic (ROC) analysis were used. Results: The patients’ age was a factor associated with the results – a significant number of patients with adverse outcome were older patients (p = 0.008), while the patients’sex was not a significantly associated factor (p = 0.999). No statistically significant relationships were found for clinical symptoms, while dyspnea showed borderline significance (p = 0.059). Significant laboratory differences were established for hematocrit (p = 0.028), urea (p=0.001), creatinine (p = 0.001), and D-dimer (p = 0.011). Categorized SAA was not significantly associated with outcome (p = 0.393). ROC analysis showed very good prognostic value of urea (AUC = 0.949) and good value of D-dimer (AUC = 0.838) for predicting adverse outcome (fatal outcome). Conclusion: Advanced age, lower hematocrit, and increased levels of urea, creatinine, and D-dimer were associated with adverse outcome in older patients with COVID-19. Urea and D-dimer may be useful markers for early risk stratification.