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Clinical Presentation and Outcome Across Age Categories among Patients with COVID-19 Admitted to a Spanish Emergency Department

European Geriatric Medicine(2020)

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摘要
According to age, there are differences in the clinical profile, presentation, management, and short-term outcomes of patients with COVID-19 admitted to the Emergency Department. A statistically significant association was found between demographic data, comorbidities, clinical, radiographic, analytical, and therapeutic variables and short-term results according to age-dependent categories. Age was a prognostic factor for hospital admission and in-hospital and 30-day mortality, and was associated with not being admitted to intensive care. Clinical presentation, management, and short-term outcomes differ according to age among patients with COVID-19 admitted to the Emergency Department. To determine the differences by age-dependent categories in the clinical profile, presentation, management, and short-term outcomes of patients with laboratory-confirmed COVID-19 admitted to a Spanish Emergency Department (ED). Secondary analysis of COVID-19_URG-HCSC registry. We included all consecutive patients with laboratory-confirmed COVID-19 admitted to the ED of the University Hospital Clinico San Carlos (Madrid, Spain). The population was divided into six age groups. Demographic, baseline and acute clinical data, and in-hospital and 30-day outcomes were collected. 1379 confirmed COVID-19 cases (mean age 62 (SD 18) years old; 53.5% male) were included (18.1% < 45 years; 17.8% 45–54 years; 17.9% 55–64 years; 17.2% 65–74 years; 17.0% 75–84 years; and 11.9% ≥ 85 years). A statistically significant association was found between demographic, comorbidity, clinical, radiographic, analytical, and therapeutic variables and short-term results according to age-dependent categories. There were less COVID-specific symptoms and more atypical symptoms among older people. Age was a prognostic factor for hospital admission (aOR = 1.04; 95% CI 1.02–1.05) and in-hospital (aOR = 1.08; 95% CI 1.05–1.10) and 30-day mortality (aOR = 1.07; 95% CI 1.04–1.09), and was associated with not being admitted to intensive care (aOR = 0.95; 95% CI 0.93–0.98). Older age is associated with less COVID-specific symptoms and more atypical symptoms, and poor short-term outcomes. Age has independent prognostic value and may help in shared decision-making in patients with confirmed COVID-19 infection.
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Age,Older,COVID-19,Emergency department
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