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Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study

BACKGROUND: The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID-19 remain unclear. OBJECTIVE: To determine the association of chronic diseases, chest computed tomography (CT), and laboratory tests with severe respiratory failure and mortality in o...

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Autores principales: Junior, Alberto Frisoli, Azevedo, Elaine, Paes, Angela Tavares, Lima, Eliene, Campos Guerra, João Carlos, Ingham, Sheila Jean Mc Neill
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8851839/
https://www.ncbi.nlm.nih.gov/pubmed/35172759
http://dx.doi.org/10.1186/s12877-022-02776-3
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author Junior, Alberto Frisoli
Azevedo, Elaine
Paes, Angela Tavares
Lima, Eliene
Campos Guerra, João Carlos
Ingham, Sheila Jean Mc Neill
author_facet Junior, Alberto Frisoli
Azevedo, Elaine
Paes, Angela Tavares
Lima, Eliene
Campos Guerra, João Carlos
Ingham, Sheila Jean Mc Neill
author_sort Junior, Alberto Frisoli
collection PubMed
description BACKGROUND: The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID-19 remain unclear. OBJECTIVE: To determine the association of chronic diseases, chest computed tomography (CT), and laboratory tests with severe respiratory failure and mortality in older adults hospitalized with COVID-19. METHOD: This was a prospective cohort with 201 hospitalized older adults with COVID-19. Chronic diseases, chest CT, laboratory tests, and other data were collected within the first 48 h of hospitalization. Outcomes were progression to severe respiratory failure with the need of mechanical ventilation (SRF/MV) and death. RESULTS: The mean age was 72.7 ± 9.2 years, and 63.2% were men. SRF/MV occurred in 16.9% (p < 0.001), and death occurred in 8%. In the adjusted regression analyses, lung involvement over 50% [odds ratio (OR): 3.09 (1.03–9.28; 0.043)], C-reactive protein (CRP) > 80 ng/mL [OR: 2.97 (0.99–8.93; 0.052)], Vitamin D < 40 ng/mL [OR: 6.41 (1.21–33.88; 0.029)], and hemoglobin < 12 g/mL [OR: 3.32 (1.20–9.20; 0.020)] were independent predictors for SFR/MV, while chronic atrial fibrillation [OR: 26.72 (3.87–184.11; 0.001)], cancer history [OR:8.32 (1.28–53.91; 0.026)] and IL-6 > 40 pg/mL [OR:10.01 (1.66–60.13; 0.012)] were independent predictors of death. CONCLUSION: In hospitalized older adults with COVID-19, tomographic pulmonary involvement > 50%, anemia, vitamin D below 40 ng/mL, and CRP above 80 mg/L were independent risk factors for progression to SRF/MV. The presence of chronic atrial fibrillation, previous cancer, IL-6 > 40 pg/mL, and anemia were independent predictors of death.
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spelling pubmed-88518392022-02-18 Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study Junior, Alberto Frisoli Azevedo, Elaine Paes, Angela Tavares Lima, Eliene Campos Guerra, João Carlos Ingham, Sheila Jean Mc Neill BMC Geriatr Research BACKGROUND: The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID-19 remain unclear. OBJECTIVE: To determine the association of chronic diseases, chest computed tomography (CT), and laboratory tests with severe respiratory failure and mortality in older adults hospitalized with COVID-19. METHOD: This was a prospective cohort with 201 hospitalized older adults with COVID-19. Chronic diseases, chest CT, laboratory tests, and other data were collected within the first 48 h of hospitalization. Outcomes were progression to severe respiratory failure with the need of mechanical ventilation (SRF/MV) and death. RESULTS: The mean age was 72.7 ± 9.2 years, and 63.2% were men. SRF/MV occurred in 16.9% (p < 0.001), and death occurred in 8%. In the adjusted regression analyses, lung involvement over 50% [odds ratio (OR): 3.09 (1.03–9.28; 0.043)], C-reactive protein (CRP) > 80 ng/mL [OR: 2.97 (0.99–8.93; 0.052)], Vitamin D < 40 ng/mL [OR: 6.41 (1.21–33.88; 0.029)], and hemoglobin < 12 g/mL [OR: 3.32 (1.20–9.20; 0.020)] were independent predictors for SFR/MV, while chronic atrial fibrillation [OR: 26.72 (3.87–184.11; 0.001)], cancer history [OR:8.32 (1.28–53.91; 0.026)] and IL-6 > 40 pg/mL [OR:10.01 (1.66–60.13; 0.012)] were independent predictors of death. CONCLUSION: In hospitalized older adults with COVID-19, tomographic pulmonary involvement > 50%, anemia, vitamin D below 40 ng/mL, and CRP above 80 mg/L were independent risk factors for progression to SRF/MV. The presence of chronic atrial fibrillation, previous cancer, IL-6 > 40 pg/mL, and anemia were independent predictors of death. BioMed Central 2022-02-17 /pmc/articles/PMC8851839/ /pubmed/35172759 http://dx.doi.org/10.1186/s12877-022-02776-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Junior, Alberto Frisoli
Azevedo, Elaine
Paes, Angela Tavares
Lima, Eliene
Campos Guerra, João Carlos
Ingham, Sheila Jean Mc Neill
Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study
title Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study
title_full Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study
title_fullStr Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study
title_full_unstemmed Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study
title_short Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study
title_sort chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly brazilian patients hospitalized with covid-19: a prospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8851839/
https://www.ncbi.nlm.nih.gov/pubmed/35172759
http://dx.doi.org/10.1186/s12877-022-02776-3
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