scholarly journals Clinical characteristics and manifestations in older patients with COVID-19

2020 ◽  
Author(s):  
Chenchen Wei ◽  
Ya Liu ◽  
Yapeng Liu ◽  
Kai Zhang ◽  
Dezhen Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Cardiovascular Diseases ◽  
Older Patients ◽  
Muscle Injury ◽  
Clinical Characteristics ◽  
Oldest Old ◽  
Cardiac Injury ◽  
Organ Damage ◽  
Old Patients

Abstract Background: To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19).Methods: In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed.Results: Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients (>75 years) had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients present more severe with the mortality of 18.6%, which was higher than that in younger and middle-aged patients (P<0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with death in older patients, while glucocorticoids may be harmful.Conclusions: Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients with COVID-19 and glucocorticoids should be carefully administered in older patients.

scholarly journals Clinical characteristics and manifestations in older patients with COVID-19

2020 ◽  
Author(s):  
Chenchen Wei ◽  
Ya Liu ◽  
Yapeng Liu ◽  
Kai Zhang ◽  
Dezhen Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Cardiovascular Diseases ◽  
Older Patients ◽  
Muscle Injury ◽  
Clinical Characteristics ◽  
Oldest Old ◽  
Cardiac Injury ◽  
Organ Damage ◽  
Old Patients

Abstract Background To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19). Methods In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed. Results Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients (> 75y) had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients present more severe and the mortality was 18.6%, which was higher than that in younger and middle-aged patients (P < 0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with the death in older patients, while glucocorticoids should be carefully administered since it may increase the mortality in older patients. Conclusions Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients and glucocorticoids may be harmful for older patients with COVID-19.

scholarly journals Clinical characteristics and manifestations in older patients with COVID-19

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chenchen Wei ◽  
Ya Liu ◽  
Yapeng Liu ◽  
Kai Zhang ◽  
Dezhen Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Cardiovascular Diseases ◽  
Older Patients ◽  
Muscle Injury ◽  
Clinical Characteristics ◽  
Oldest Old ◽  
Cardiac Injury ◽  
Organ Damage ◽  
Old Patients

Abstract Background To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19). Methods In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed. Results Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients presented more severe with the mortality of 18.6%, which was higher than that in younger and middle-aged patients (P < 0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with death in older patients, while glucocorticoids might be harmful. Conclusions Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients with COVID-19 and glucocorticoids should be carefully administered in older patients.

scholarly journals Clinical characteristics and manifestations in older patients with COVID-19

2020 ◽  
Author(s):  
Chenchen Wei ◽  
Ya Liu ◽  
Yapeng Liu ◽  
Kai Zhang ◽  
Dezhen Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Cardiovascular Diseases ◽  
Older Patients ◽  
Muscle Injury ◽  
Clinical Characteristics ◽  
Oldest Old ◽  
Cardiac Injury ◽  
Organ Damage ◽  
Old Patients

Abstract Background: To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19).Methods: In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed.Results: Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients (>75 years) had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients present more severe with the mortality of 18.6%, which was higher than that in younger and middle-aged patients (P<0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with death in older patients, while glucocorticoids may be harmful.Conclusions: Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients with COVID19 and glucocorticoids should be carefully administered in older patients.

scholarly journals Clinical characteristics and manifestations in older patients with COVID-19

2020 ◽  
Author(s):  
Chenchen Wei ◽  
Ya Liu ◽  
Yapeng Liu ◽  
Kai Zhang ◽  
Dezhen Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Cardiovascular Diseases ◽  
Older Patients ◽  
Muscle Injury ◽  
Clinical Characteristics ◽  
Oldest Old ◽  
Cardiac Injury ◽  
Organ Damage ◽  
Old Patients

Abstract Background: To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19).Methods: In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed.Results: Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients (>75 years) had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients present more severe with the mortality of 18.6%, which was higher than that in younger and middle-aged patients (P<0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with death in older patients, while glucocorticoids may be harmful.Conclusions: Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients with COVID19 and glucocorticoids should be carefully administered in older patients.

Treating Heart Failure in Older and Oldest Old Patients.

2015 ◽  
Vol 21 (13) ◽  
pp. 1659-1664 ◽  
Author(s):  
Davide Vetrano ◽  
Fabrizia Lattanzio ◽  
Anna Martone ◽  
Francesco Landi ◽  
Vincenzo Brandi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Oldest Old ◽  
Old Patients

Effectiveness of nurse-led hospital-based heart failure programmes in octagenarians and nonagenarians: is age important?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Guerrero ◽  
L Alcoberro ◽  
J Vime ◽  
E Calero ◽  
E Hidalgo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Usual Care ◽  
Cox Regression ◽  
Oldest Old ◽  
Primary Diagnosis ◽  
Care Group ◽  
Old Patients ◽  
End Point ◽  
Period 2 ◽  
Intervention Modality

Abstract Background Efficacy of HF programmes in oldest old (octogenarians and nonagenarians) has not been fully explored. Methods We conducted a natural experiment evaluating all patients after hospitalization for heart failure as primary diagnosis between January 2017 and January 2019. We compared outcomes between patients discharged during Period #1, before the implementation of the program with patients discharged during Period #2, after the implementation of the 7-step bundle of interventions. We explored the interaction between age group (&lt;80 vs. ≥80 years old) by the intervention modality (HF programme vs. usual care). Primary end-point was the combined end-point of all-cause death or all-cause hospitalization at 6 months after discharge from the index hospitalization. Results The study enroled 440 patients. Mean age of the whole cohort was 75±9 years. In the oldest old subgroup (n=160), mean age was 84±3. No differences were found in baseline characteristics of patients between usual care and HF program. 30-day all-cause readmission was significantly reduced in patients in the HF programme group compared to patients in the usual care group in both age strata. In unadjusted Cox regression analyses in the oldest old group, management of patients in the HF programme was significanty associated with a reduction in the risk of the primary end-point (HR: 0.50; 95% CI [0.29–0.85]; p=0.011). Conclusions Management of patients in a nurse-led integrated care-based heart failure programme results in reduction of all-cause death or all-cause hospitalizations in oldest old patients. Event-free survival cumulative curves. Funding Acknowledgement Type of funding source: None

B-type natriuretic peptides for the diagnosis of congestive heart failure in dyspneic oldest-old patients

2008 ◽  
Vol 41 (13) ◽  
pp. 1049-1054 ◽  
Author(s):  
Camille Chenevier-Gobeaux ◽  
Samuel Delerme ◽  
Jean-Christophe Allo ◽  
Martine Arthaud ◽  
Yann-Erick Claessens ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Natriuretic Peptides ◽  
Oldest Old ◽  
Old Patients

scholarly journals Cardiovascular Diseases and COVID-19 Mortality and Intensive Care Unit Admission: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Amir Shamshirian ◽  
Keyvan Heydari ◽  
Reza Alizadeh-Navaei ◽  
Mahmood Moosazadeh ◽  
Saeed Abrotan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiovascular Diseases ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
Icu Admission ◽  
The World

AbstractImportanceOn 11th March, the World Health Organization declared a pandemic of COVID-19. There are over 1 million cases around the world with this disease and it continues to raise. Studies on COVID-19 patients have reported high rate of cardiovascular disease (CVD) among them and patients with CVD had higher mortality rate.ObjectivesSince there were controversies between different studies about CVD burden in COVID-19 patients, we aimed to study cardiovascular disease burden among COVID-19 patients using a systematic review and meta-analysis.Data SourcesWe have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar.Study SelectionStudies reported cardiovascular disease among hospitalized adult COVID-19 patients with mortality or ICU admission (primary outcomes) were included into meta-analysis. In addition, all of studies which reported any cardiovascular implication were included for descriptive meta-analysis. Cohort studies, case-control, cross-sectional, case-cohort and case series studies included into the study. Finally, 16 studies met the inclusion criteria for primary outcome and 59 studies for descriptive outcome.Data Extraction and SynthesisTwo investigators have independently evaluated quality of publications and extracted data from included papers. In case of disagreement a supervisor solved the issue and made the final decision. Quality assessment of studies was done using Newcastle-Ottawa Scale tool. Heterogeneity was assessed using I-squared test and in case of high heterogeneity (>%50) random effect model was used.Main Outcomes and MeasuresMeta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs and Standardized Mean Difference (SMD) was calculated for Cardiac Troponin I. We have also performed a descriptive meta-analysis on different CVDs.ResultsSixteen papers including 3473 patients entered into meta-analysis for ICU admission and mortality outcome and fifty-nine papers including 9509 patients for descriptive outcomes. Results of meta-analysis indicated that acute cardiac injury, (OR: 15.94, 95% CI 2.31-110.14), hypertension (OR: 1.92, 95% CI 1.92-2.74), heart Failure (OR: 11.73, 95% CI 5.17-26.60), other cardiovascular disease (OR: 1.95, 95% CI 1.17-3.24) and overall CVDs (OR: 3.37, 95% CI 2.06-5.52) were significantly associated with mortality in COVID-19 patients. Arrhythmia (OR: 22.17, 95%CI 4.47-110.04), acute cardiac injury (OR: 19.83, 95%CI 7.85-50.13), coronary heart disease (OR: 4.19, 95%CI 1.27-13.80), cardiovascular disease (OR: 4.17, 95%CI 2.52-6.88) and hypertension (OR: 2.69, 95%CI 1.55-4.67) were also significantly associated with ICU admission in COVID-19 patients.ConclusionOur findings showed a high burden of CVDs among COVID-19 patients which was significantly associated with mortality and ICU admission. Proper management of CVD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations.Key PointsQuestionAre cardiovascular disease associated with mortality and Intensive Care Unit admission (ICU) of COVID-19 patients?FindingsIn this systematic review and meta-analysis, acute cardiac injury, hypertension, heart failure and overall cardiovascular diseases were significantly associated with mortality in COVID-19 patients. Arrhythmia, coronary heart disease, hypertension, acute cardiac injury and other cardiovascular disease were significantly associated with ICU admission of COVID-19 patients.MeaningCardiovascular diseases have significant role in mortality and disease severity of COVID-19 patients. COVID-19 patients need to be carefully monitored for cardiovascular diseases and managed properly in case of acute cardiac conditions.

scholarly journals Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study

BMJ ◽  
2020 ◽  
pp. m1091 ◽  
Author(s):  
Tao Chen ◽  
Di Wu ◽  
Huilong Chen ◽  
Weiming Yan ◽  
Danlei Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Characteristics ◽  
Distress Syndrome ◽  
Cardiac Injury ◽  
Cardiac Complications ◽  
Type I

Abstract Objective To delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died. Design Retrospective case series. Setting Tongji Hospital in Wuhan, China. Participants Among a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020. Main outcome measures Clinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms. Results The median age of deceased patients (68 years) was significantly older than recovered patients (51 years). Male sex was more predominant in deceased patients (83; 73%) than in recovered patients (88; 55%). Chronic hypertension and other cardiovascular comorbidities were more frequent among deceased patients (54 (48%) and 16 (14%)) than recovered patients (39 (24%) and 7 (4%)). Dyspnoea, chest tightness, and disorder of consciousness were more common in deceased patients (70 (62%), 55 (49%), and 25 (22%)) than in recovered patients (50 (31%), 48 (30%), and 1 (1%)). The median time from disease onset to death in deceased patients was 16 (interquartile range 12.0-20.0) days. Leukocytosis was present in 56 (50%) patients who died and 6 (4%) who recovered, and lymphopenia was present in 103 (91%) and 76 (47%) respectively. Concentrations of alanine aminotransferase, aspartate aminotransferase, creatinine, creatine kinase, lactate dehydrogenase, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer were markedly higher in deceased patients than in recovered patients. Common complications observed more frequently in deceased patients included acute respiratory distress syndrome (113; 100%), type I respiratory failure (18/35; 51%), sepsis (113; 100%), acute cardiac injury (72/94; 77%), heart failure (41/83; 49%), alkalosis (14/35; 40%), hyperkalaemia (42; 37%), acute kidney injury (28; 25%), and hypoxic encephalopathy (23; 20%). Patients with cardiovascular comorbidity were more likely to develop cardiac complications. Regardless of history of cardiovascular disease, acute cardiac injury and heart failure were more common in deceased patients. Conclusion Severe acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk. Acute respiratory distress syndrome and respiratory failure, sepsis, acute cardiac injury, and heart failure were the most common critical complications during exacerbation of covid-19.

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