Mortality in hospitalized older adults with COVID-19 during three waves : A multicenter retrospective cohort study
© 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC..
Background: The waves of COVID-19 infections in Ontario, Canada, were marked by differences in patient characteristics and treatment. Our objectives were to (i) describe patient characteristics, treatment, and outcomes of hospitalized older adults with COVID-19 between waves 1, 2, and 3, (ii) determine if there was an improvement in in-hospital mortality in waves 2 and 3 after adjusting for covariates.
Methods: This retrospective cohort study was done in five acute care hospitals in Toronto, Ontario. Consecutive hospitalized older adults aged ≥65 years with confirmed COVID-19 infection were included. Wave 1 extended from March 11 to July 31, 2020, wave 2 from August 1, 2020 to February 20, 2021, and wave 3 from February 21 to June 30, 2021. Patient characteristics and outcomes were abstracted from charts. A logistic regression model was used to determine the association between COVID-19 and in-hospital mortality in waves 2 and 3 compared with wave 1.
Results: Of the 1671 patients admitted to acute care, 297 (17.8%) were admitted in wave 1, 751 (44.9%) in wave 2, and 623 (37.3%) in wave 3. The median age of our cohort was 77.0 years (interquartile range: 71.0-85.0) and 775 (46.4%) were female. The prevalence of frailty declined in progressive waves. The use of dexamethasone, remdesivir, and tocilizumab was significantly higher in waves 2 and 3 compared with wave 1. In the unadjusted analysis, in-hospital mortality was unchanged between waves 1 and 2, but it was lower in wave 3 (18.3% vs. 27.4% in wave 1). After adjustment, in-hospital mortality was unchanged in waves 2 and 3 compared with wave 1.
Conclusion: In-hospital mortality in hospitalized older adults with COVID-19 was similar between waves 1 and 3. Further research should be done to determine if COVID-19 therapies have similar benefits for older adults compared with younger adults.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
Health science reports - 5(2022), 3 vom: 18. Mai, Seite e603 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wong, Eric Kai Chung [VerfasserIn] |
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| Links: |
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| Themen: |
Aging |
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| Anmerkungen: |
Date Revised 16.07.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1002/hsr2.603 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM340380373 |
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| 100 | 1 | |a Wong, Eric Kai Chung |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Mortality in hospitalized older adults with COVID-19 during three waves |b A multicenter retrospective cohort study |
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| 500 | |a published: Electronic-eCollection | ||
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| 520 | |a © 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC. | ||
| 520 | |a Background: The waves of COVID-19 infections in Ontario, Canada, were marked by differences in patient characteristics and treatment. Our objectives were to (i) describe patient characteristics, treatment, and outcomes of hospitalized older adults with COVID-19 between waves 1, 2, and 3, (ii) determine if there was an improvement in in-hospital mortality in waves 2 and 3 after adjusting for covariates | ||
| 520 | |a Methods: This retrospective cohort study was done in five acute care hospitals in Toronto, Ontario. Consecutive hospitalized older adults aged ≥65 years with confirmed COVID-19 infection were included. Wave 1 extended from March 11 to July 31, 2020, wave 2 from August 1, 2020 to February 20, 2021, and wave 3 from February 21 to June 30, 2021. Patient characteristics and outcomes were abstracted from charts. A logistic regression model was used to determine the association between COVID-19 and in-hospital mortality in waves 2 and 3 compared with wave 1 | ||
| 520 | |a Results: Of the 1671 patients admitted to acute care, 297 (17.8%) were admitted in wave 1, 751 (44.9%) in wave 2, and 623 (37.3%) in wave 3. The median age of our cohort was 77.0 years (interquartile range: 71.0-85.0) and 775 (46.4%) were female. The prevalence of frailty declined in progressive waves. The use of dexamethasone, remdesivir, and tocilizumab was significantly higher in waves 2 and 3 compared with wave 1. In the unadjusted analysis, in-hospital mortality was unchanged between waves 1 and 2, but it was lower in wave 3 (18.3% vs. 27.4% in wave 1). After adjustment, in-hospital mortality was unchanged in waves 2 and 3 compared with wave 1 | ||
| 520 | |a Conclusion: In-hospital mortality in hospitalized older adults with COVID-19 was similar between waves 1 and 3. Further research should be done to determine if COVID-19 therapies have similar benefits for older adults compared with younger adults | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aging | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a geriatrics | |
| 650 | 4 | |a healthcare management | |
| 700 | 1 | |a Watt, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Zou, Hanyan |e verfasserin |4 aut | |
| 700 | 1 | |a Chandraraj, Arthana |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Alissa W |e verfasserin |4 aut | |
| 700 | 1 | |a Norman, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Piggott, Katrina Lynn |e verfasserin |4 aut | |
| 700 | 1 | |a Straus, Sharon E |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Barbara |e verfasserin |4 aut | |
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