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

DOI record: { "DOI": "10.1186/s12877-022-02776-3", "ISSN": [ "1471-2318" ], "URL": "http://dx.doi.org/10.1186/s12877-022-02776-3", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID-19 remain unclear.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Objective</jats:title>\n <jats:p>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.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Method</jats:title>\n <jats:p>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.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>The mean age was 72.7 ± 9.2 years, and 63.2% were men. SRF/MV occurred in 16.9% (<jats:italic>p</jats:italic> &lt; 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) &gt; 80 ng/mL [OR: 2.97 (0.99–8.93; 0.052)], Vitamin D &lt; 40 ng/mL [OR: 6.41 (1.21–33.88; 0.029)], and hemoglobin &lt; 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 &gt; 40 pg/mL [OR:10.01 (1.66–60.13; 0.012)] were independent predictors of death.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>In hospitalized older adults with COVID-19, tomographic pulmonary involvement &gt; 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 &gt; 40 pg/mL, and anemia were independent predictors of death.</jats:p>\n </jats:sec>", "alternative-id": [ "2776" ], "article-number": "132", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "27 September 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "18 January 2022" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "17 February 2022" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Ethics approval and consent to participate", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "The authors confirm that all the methodology used in this study was carried out in accordance with the relevant ethical guidelines and regulations described in the Declaration of Helsinky. All participants or caregivers / family members signed the Informed Consent Form (ICF). The signing was performed in person by a member of the study team or through an electronic document sent to the participant, after a phone call in which the ICF was read and explained by a member of the study team. The project and Informed Consent Form (ICF) were approved by the Ethics Committee of the Hospital Israelita Albert Einstein and of Plataforma Brasil under the numbers: 4.082.096 e 4.186.636 ." }, { "group": { "label": "Consent for publication", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "Not applicable." }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "The authors declare that they have no competing interests." } ], "author": [ { "affiliation": [], "family": "Junior", "given": "Alberto Frisoli", "sequence": "first" }, { "affiliation": [], "family": "Azevedo", "given": "Elaine", "sequence": "additional" }, { "affiliation": [], "family": "Paes", "given": "Angela Tavares", "sequence": "additional" }, { "affiliation": [], "family": "Lima", "given": "Eliene", "sequence": "additional" }, { "affiliation": [], "family": "Campos Guerra", "given": "João Carlos", "sequence": "additional" }, { "affiliation": [], "family": "Ingham", "given": "Sheila Jean Mc Neill", "sequence": "additional" } ], "container-title": [ "BMC Geriatrics" ], "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2022, 2, 17 ] ], "date-time": "2022-02-17T04:25:44Z", "timestamp": 1645071944000 }, "deposited": { "date-parts": [ [ 2022, 2, 17 ] ], "date-time": "2022-02-17T04:26:24Z", "timestamp": 1645071984000 }, "indexed": { "date-parts": [ [ 2022, 2, 17 ] ], "date-time": "2022-02-17T04:41:27Z", "timestamp": 1645072887194 }, "is-referenced-by-count": 0, "issn-type": [ { "type": "electronic", "value": "1471-2318" } ], "issue": "1", "issued": { "date-parts": [ [ 2022, 2, 17 ] ] }, "journal-issue": { "issue": "1", "published-print": { "date-parts": [ [ 2022, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 2, 17 ] ], "date-time": "2022-02-17T00:00:00Z", "timestamp": 1645056000000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 2, 17 ] ], "date-time": "2022-02-17T00:00:00Z", "timestamp": 1645056000000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1186/s12877-022-02776-3.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1186/s12877-022-02776-3/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1186/s12877-022-02776-3.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1186", "published": { "date-parts": [ [ 2022, 2, 17 ] ] }, "published-online": { "date-parts": [ [ 2022, 2, 17 ] ] }, "published-print": { "date-parts": [ [ 2022, 12 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.15585/mmwr.mm6912e2", "doi-asserted-by": "publisher", "key": "2776_CR1", "unstructured": "CDC COVID-19 Response Team. 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