Ahmad Mahdi, MD
Internal Medicine Resident
Marshall University
Huntington, West Virginia
Disclosure information not submitted.
Mahmoud Abouzid, MD
Resident
Marshall University, United States
Disclosure information not submitted.
Rodrigo Aguilar, MD
Resident
Marshall University, United States
Disclosure information not submitted.
Yousef Shweihat, MD
Professor
Marshall University, United States
Disclosure information not submitted.
Ghassan Bandak, MD, MBBS
Marshall University
Huntington, West Virginia
Disclosure information not submitted.
Title: Clinical Features and Outcomes of Critically Ill Elderly Patients With COVID 19 Infection
Introduction: The COVID 19 pandemic has affected millions of people of all age groups. COVID 19 infections can cause significant morbidity and mortality, especially among elderly patients and those with comorbidities. Outcomes of elderly patients who are critically ill with COVID 19 infection are not well defined. We present here a study about this population in our community defining their clinical features and outcomes.
Methods: All patients age 65 years and above, with a positive COVID 19 diagnosis, and who were admitted to the ICU of a tertiary academic medical center in Huntington, WV, between March 2020 to April 2021, were included in this retrospective observational study. Given sample size, Fisher exact test was used for most calculations. Wilcoxon Rank Sum test was used to analyze length of stay. All statistical analyses were performed using SAS version 9.4 (SAS Institute, Cary, North Carolina). All p-values were based on 2-tailed tests and were considered statistically significant when p < 0.05.
Results: Sixty-eight patients met inclusion criteria. The mean age was 74 years (SD 7.4). Most patients were male (n=41, 60.29%) and White (n=63, 92.6%). Significant comorbidities included hypertension (n=53, 77.94%), diabetes mellitus (n=40, 58.82%), chronic kidney disease (n=23, 33.82%), chronic obstructive pulmonary disease (n=19, 27.94%) and 14 patients (20.6%) were on oxygen supplementation at home. At the time of ICU admission, most patients required high flow nasal cannula or noninvasive ventilation (n=45, 66.2%), followed by mechanical ventilation (MV) (n=17, 25%). Only 6 patients (8.8%) had a “do not intubate” order at time of ICU admission. Thirty-nine patients (57.4%) required MV during their stay. The mean ICU length of stay (LOS) was 11.0 days (SD 9.2), and the mean hospital LOS was 18.9 days (SD 12.1). Mortality occurred in 43 patients (63.24%). However, mortality rate was higher among patients who required MV compared to those who did not (74.36% vs 48.28% respectively, p=0.02)
Conclusions: Elderly patients with COVID 19 infection who require ICU admission have high rates of comorbidities. More than half of these patients will require MV and require long ICU and hospital stays. The mortality of this population is high over all, and specifically higher among those who require MV.