NCT
HOME CURRENT ARCHIVE COVID-19
HOME CURRENT ARCHIVE PUBLISH INSTRUCTIONS
FOR AUTHORS COVID-19 LOG IN / REGISTER HISTORY ABOUT US DIRECTORY CONTACT
COVID-19 in older adults Mexican, descriptive analysis

Sánchez-Ríos, Carla Paola1; Barreto-Rodríguez, José Omar1; Centeno-Sáenz, Gustavo Iván1; Vázquez-Rojas, Hazel1





2020, Number 4

2020; 79 (4)






ABSTRACT

Introduction: The elderly may represent a specific group of patients at high risk for developing COVID-19 with rapidly progressive clinical deterioration. In fact, in older individuals, immunosenescence and comorbid disorders are more likely to promote a virus-induced cytokine storm resulting in life-threatening respiratory failure and multi-system compromise. Material and methods: A descriptive study of the geriatric population with COVID-19 disease attended at the National Institute of Respiratory Diseases, Mexico City, Mexico in the period March-May 2020 was carried out. 35 hospitalized adult patients over 60 years were confirmed by RT PCR. for COVID-19 disease in pharyngeal exudate. Descriptive statistics were used and results were expressed using measures of central tendency. Results: A total sample of 35 patients was analyzed. 62.85% were male (n = 22). Systemic arterial hypertension was documented in 51.42% (n = 18), obesity in 48.57% (n = 17) and diabetes mellitus in 34.28% (n = 12). The severity of the COVID-19 disease at the time of hospital admission was: mild in 22.85% (n = 8), moderate in 42.85% (n = 15) and severe or critical in 34.28% (n = 12). 80% (n = 28) consulted after presenting symptoms for more than five days. The tomographic findings were ground glass pattern in 82.85% (n = 29), consolidation in 14.28% (n = 5) and "crazy paving" in only one patient (2.8%). The mortality registered in geriatric patients with COVID-19 was 68.57%. Conclusions: The geriatric population is considered vulnerable for the development of COVID-19 disease and for fatal outcomes. Patients with moderate disease should be closely monitored as they tend to eventually develop critical forms. The fatality of COVID-19 disease in older adult patients is high.

KEYWORDS

Older adult, COVID-19, prognosis.

REFERENCES

  1. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report-97. Geneva: World Health Organization; 2020.

  2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497-506. https://doi.org/10.1016/s0140-6736(20)30183-5

  3. Masters PS. The molecular biology of coronaviruses. Adv Virus Res. 2006;66:193-292. https://doi.org/10.1016/s0065-3527(06)66005-3

  4. Kang S, Peng W, Zhu Y, Lu S, Zhou M, Lin W, et al. Recent progress in understanding 2019 novel coronavirus (SARS-CoV-2) associated with human respiratory disease: detection, mechanisms and treatment. Int J Antimicrob Agents. 2020;55(5):105950. https://doi.org/10.1016/j.ijantimicag.2020.105950

  5. Gorbalenya AE, Baker SC, Baric RS, et al; Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-544. https://doi.org/10.1038/s41564-020-0695-z

  6. Zhou P, Yang XL, Wang XG, Hu B, Zhang W, Si HR, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273. https://doi.org/10.1038/s41586-020-2012-7

  7. World Health Organization. Novel coronavirus (2019-nCoV) situation report-22. Geneve: World Health Organization; 2020. https://apps.who.int/iris/handle/10665/330991

  8. World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations. Geneva: World Health Organization; 2020. p. 10-12.

  9. Xu Y, Li X, Zhu B, Liang H, Fang Ch, Gong Y, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med. 2020;26(4):502-505. https://doi.org/10.1038/s41591-020-0817-4

  10. Hindson J. COVID-19: faecal-oral transmission? Nat Rev Gastroenterol Hepatol. 2020;17(5):259. https://doi.org/10.1038/s41575-020-0295-7

  11. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. https://doi.org/10.1016/s0140-6736(20)30211-7

  12. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. https://doi.org/10.1056/nejmoa2001017

  13. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. https://doi.org/10.1016/s0140-6736(20)30566-3

  14. Nishiura H, Kobayashi T, Miyama T, Suzuki A, Jung SM, Hayashi K, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis. 2020;94:154-155. https://doi.org/10.1016/j.ijid.2020.03.020

  15. Libertini G, Corbi G, Cellurale M, Ferrara N. Age-related dysfunctions: evidence and relationship with some risk factors and protective drugs. Biochemistry (Mosc). 2019;84(12):1442-1450. https://doi.org/10.1134/s0006297919120034

  16. Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World J Cardiol. 2012;4(5):135-147. https://doi.org/10.4330/wjc.v4.i5.135

  17. Suastika K, Dwipayana P, Saraswati IMR, Kuswardhani T, Astika N, Putrawan IB, et al. Relationship between age and metabolic disorders in the population of Bali. J Clin Gerontol Geriatr. 2011;2:47-52. https://doi.org/10.1016/j.jcgg.2011.03.001

  18. Palmieri L, Andrianou X, Barbariol P. Characteristics of SARS-CoV-2 patients dying in Italy report based on available data on April 16th, 2020. Access date: 2020 November 19. Available in: https://www.epicentro.iss.it/en/coronavirus/bollettino/Report-COVID-2019_29_april_2020.pdf

  19. Wang L, He W, Yu X, Hu D, Bao M, Liu H, et al. Coronavirus disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;80(6):639-645. https://doi.org/10.1016/j.jinf.2020.03.019

  20. Aw D, Silva AB, Palmer DB. Immunosenescence: emerging challenges for an ageing population. Immunology. 2007;120(4):435-446. https://doi.org/10.1111/j.1365-2567.2007.02555.x

  21. Longobardi L, Giorgio AD, Perrotta F, Costigliola A, Cerqua FS, Cioffi G, et al. Bronchial asthma in the elderly patient. JGG. 2016;64:55-65.

  22. Mollica M, Nicolai A, Maffucci R, Gioia MR, Paoli G, Grella E, et al. Obstructive sleep apnea and cardiovascular risks in the elderly population. JGG. 2018;66(3):149-155.

  23. Karlberg J, Chong DS, Lai WY. Do men have a higher case fatality rate of severe acute respiratory syndrome than women do? Am J Epidemiol. 2004;159(3):229-231. https://doi.org/10.1093/aje/kwh056

  24. Leong HN, Earnest A, Lim HH, Chin CF, Tan C, Puhaindran ME, et al. SARS in Singapore--predictors of disease severity. Ann Acad Med Singap. 2006;35(5):326-331.

  25. Alghamdi IG, Hussain II, Almalki SS, Alghamdi MS, Alghamdi MM, El-Sheemy MA. The pattern of Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive epidemiological analysis of data from the Saudi Ministry of Health. Int J Gen Med. 2014;7:417-423. https://doi.org/10.2147/ijgm.s67061

  26. Conti P, Younes A. Coronavirus COV-19/SARS-CoV-2 affects women less than men: clinical response to viral infection. J Biol Regul Homeost Agents. 2020;34(2):339-343. https://doi.org/10.23812/editorial-conti-3

  27. Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: a comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-e18. https://doi.org/10.1016/j.jinf.2020.03.005

  28. Covino M, De Matteis G, Santoro M, Sabia L, Simeoni B, Candelli M, et al. Clinical characteristics and prognostic factors in COVID-19 patients aged ≥80 years. Geriatr Gerontol Int. 2020;20(7):704-708. https://doi.org/10.1111/ggi.13960

  29. Lee EYP, Ng MY, Khong PL. COVID-19 pneumonia: what has CT taught us? Lancet Infect Dis. 2020;20(4):384-385. https://doi.org/10.1016/s1473-3099(20)30134-1

  30. Rinaldi L, Milione S, Fascione MC, Pafundi PC, Altruda C, Di Caterino M, et al. Relevance of lung ultrasound in the diagnostic algorithm of respiratory diseases in a real-life setting: a multicentre prospective study. Respirology. 2010;25(5):535-542. https://doi.org/10.1111/resp.13659

  31. World Health Organization. Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises: a WHO guide. Geneva: World Health Organization; 2018.

  32. Nacoti M, Ciocca A, Giupponi A, Brambillasca P, Lussana F, Pisano M, et al. At the epicenter of the Covid-19 pandemic and humanitarian crises in Italy: changing perspectives on preparation and mitigation. NEJM Catal Innov Care Deliv. 2020;1:1-5.


2020, Number 4

2020; 79 (4)