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 et al.,
Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure..,
BMC Geriatrics, doi:10.1186/s12877-022-02776-3
Prospective study of 201 COVID+ hospitalized adults in Brazil, mean age 73, showing a lower risk of mortality and respiratory failure with vitamin D supplementation in unadjusted results, without statistical significance, and a higher risk of progression to mechanical ventilation with vitamin D levels <40ng/dl.
risk of death, 22.1% lower, RR 0.78, p = 0.61, treatment 8 of 113 (7.1%), control 8 of 88 (9.1%), NNT 50, excluded in exclusion analyses:
unadjusted results with no group details.
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risk of progression, 30.8% lower, RR 0.69, p = 0.26, treatment 16 of 113 (14.2%), control 18 of 88 (20.5%), NNT 16, respiratory failure, excluded in exclusion analyses:
unadjusted results with no group details.
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risk of mechanical ventilation, 84.4% lower, OR 0.16, p = 0.03, cutoff 40ng/dl, inverted to make OR<1 favor high D levels (≥40ng/dl), cutoff ≥40ng/dl, risk of mechanical ventilation for vitamin D levels >40ng/ml, RR approximated with OR, outcome based on serum levels.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Junior et al., 17 Feb 2022, prospective, Brazil, peer-reviewed, 6 authors, dosage not specified.
Abstract: (2022) 22:132
Junior et al. BMC Geriatrics
https://doi.org/10.1186/s12877-022-02776-3
Open Access
RESEARCH
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
Alberto Frisoli Junior1,2*, Elaine Azevedo1,3, Angela Tavares Paes1,4, Eliene Lima2,
João Carlos Campos Guerra1 and Sheila Jean Mc Neill Ingham2
Abstract
Background: The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID19 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.
Keywords: COVID-19, Respiratory failure, Elderly, Mortality, Vitamin D, Anemia
*Correspondence: frisoli@uol.com.br
2
Elderly Vulnerability Disease Research Group Unit, Cardiology Division,
Federal University of São Paulo, Rua Napoleão de Barros, 715 – Térreo‑ Vila
Clementino, São Paulo, SP Zip code: 04024‑002, Brazil
Full list of author information is available at the end of the article
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