NYMC Faculty Publications

Characteristics and Outcomes of Patients 80 Years and Older Hospitalized With Coronavirus Disease 2019 (COVID-19)

Author Type(s)

Faculty

DOI

10.1097/CRD.0000000000000368

Journal Title

Cardiology in Review

First Page

39

Last Page

42

Document Type

Article

Publication Date

1-2021

Department

Medicine

Keywords

Academic Medical Centers, Accidental Falls, Acute Kidney Injury, Aged, 80 and over, Arrhythmias, Cardiac, Aspartate Aminotransferases, C-Reactive Protein, COVID-19, Cardiovascular Diseases, Cause of Death, Consciousness Disorders, Dyspnea, Female, Ferritins, Fever, Fibrin Fibrinogen Degradation Products, Hospital Mortality, Hospitalization, Humans, Hypoxia, Independent Living, Intensive Care Units, Intracranial Hemorrhages, Leukocyte Count, Liver Diseases, Lymphocyte Count, Male, Muscle Weakness, Natriuretic Peptide, Brain, Nursing Homes, Oxygen Inhalation Therapy, Procalcitonin, Renal Replacement Therapy, Respiration, Artificial, Stroke, Troponin I, Vasoconstrictor Agents

Disciplines

Medicine and Health Sciences

Abstract

Patients older than 65 years hospitalized with COVID-19 have higher rates of intensive care unit admission and death when compared with younger patients. Cardiovascular conditions associated with COVID-19 include myocardial injury, acute myocarditis, cardiac arrhythmias, cardiomyopathies, cardiogenic shock, thromboembolic disease, and cardiac arrest. Few studies have described the clinical course of those at the upper extreme of age. We characterize the clinical course and outcomes of 73 patients with 80 years of age or older hospitalized at an academic center between March 15 and May 13, 2020. These patients had multiple comorbidities and often presented with atypical clinical findings such as altered sensorium, generalized weakness and falls. Cardiovascular manifestations observed at the time of presentation included new arrhythmia in 7/73 (10%), stroke/intracranial hemorrhage in 5/73 (7%), and elevated troponin in 27/58 (47%). During hospitalization, 38% of all patients required intensive care, 13% developed a need for renal replacement therapy, and 32% required vasopressor support. All-cause mortality was 47% and was highest in patients who were ever in intensive care (71%), required mechanical ventilation (83%), or vasopressors (91%), or developed a need for renal replacement therapy (100%). Patients older than 80 years old with COVID-19 have multiple unique risk factors which can be associated with increased cardiovascular involvement and death.

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