Journal article

Clinical presentation and outcome across age categories among patients with COVID-19 admitted to a Spanish Emergency Department.

  • Martín-Sánchez FJ Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain. fjjms@hotmail.com.
  • Del Toro E Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Cardassay E Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Valls Carbó A Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.
  • Cuesta F Department of Geriatric, Hospital Clínico San Carlos, Madrid, Spain.
  • Vigara M Department of Geriatric, Hospital Clínico San Carlos, Madrid, Spain.
  • Gil P Department of Geriatric, Hospital Clínico San Carlos, Madrid, Spain.
  • López Picado AL Institute for Health Research of Hospital San Carlos, Madrid, Spain.
  • Martínez Valero C Institute for Health Research of Hospital San Carlos, Madrid, Spain.
  • Miranda JD Risk Modelling Division of Repsol, Madrid, Spain.
  • Lopez-Ayala P Cardiovascular Research Institute Basel (CRIB), Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
  • Chaparro D Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Cozar López G Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Del Mar Suárez-Cadenas M Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Jerez Fernández P Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Angós B Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Díaz Del Arco C Department of Pathological Anatomy, Hospital Clínico San Carlos, Madrid, Spain.
  • Rodríguez Adrada E Institute for Health Research of Hospital San Carlos, Madrid, Spain.
  • Montalvo Moraleda MT Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.
  • Espejo Paeres C Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain.
  • Fernández Alonso C Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Elvira C Department of Admissions and Clinical Documentation, Hospital Clínico San Carlos, Madrid, Spain.
  • Chacón A Department of Admissions and Clinical Documentation, Hospital Clínico San Carlos, Madrid, Spain.
  • García Briñón MÁ Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • Fernández Rueda JL Department of Information Systems and Technologies, Hospital Clínico San Carlos, Madrid, Spain.
  • Ortega L Department of Pathological Anatomy, Hospital Clínico San Carlos, Madrid, Spain.
  • Fernández Pérez C Department of Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain.
  • González Armengol JJ Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
  • González Del Castillo J Department of Emergency, Hospital Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain.
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  • 2020-07-17
Published in:
  • European geriatric medicine. - 2020
English PURPOSE
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).


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Language
  • English
Open access status
bronze
Identifiers
Persistent URL
https://sonar.ch/global/documents/282859
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