COVID-19 in Geriatric Patients

Orkun Sarıçam; Gülhan Sarıçam

doi:10.31067/acusaglik.1019135

Research Article

COVID-19 in Geriatric Patients

Year 2022, , 323 - 329, 01.07.2022

Orkun Sarıçam , Gülhan Sarıçam

https://doi.org/10.31067/acusaglik.1019135

Abstract

Objective: Considering the ongoing pneumonia epidemic associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), aging is a major risk factor alone for serious illness and death. In this study, we aimed to investigate the length of stay, hospital discharge status, and prognostic factors in geriatric patients with COVID-19.
Methods: Medical files of 199 patients over the age of 65 years, who were treated as inpatients due to the diagnosis of COVID-19, were reviewed retrospectively. Demographic characteristics, comorbid diseases, laboratory values, the length of stay, and hospital discharge status of eligible patients were evaluated.
Results: Of inpatients with COVID-19, the mean age was 75.01±7.86 years and 50.8% were men. In patients, who were transferred to ICU, C-reactive protein (CRP) and ferritin levels were higher compared to patients discharged to home and the monocyte/HDL ratio (MHR) was higher compared to nonsurvivors (p=0.037, p=0.003, p=0.023). Nonsurvivors had significantly higher white blood cell (WBC) counts and erythrocyte sedimentation rates (ESR) compared to patients discharged to home. Nonsurvivors had a significantly shorter length of hospital stay compared to patients, who were transferred to ICU.
Conclusion: Geriatric patients are susceptible to adverse clinical outcomes of COVID-19. We think that WBC, ESR, CRP, ferritin, and MHR levels may inform about poor prognosis and the potential discharge status in elderly patients with COVID-19 pneumonia. Gaining insight into poor prognostic factors in elderly patients is essential to control COVID-19 and develop rapid treatment strategies in this age group.

Keywords

Geriatrics, COVID 19, İnflammation.

References

1. WHO. 2020. Coronavirus disease 2019 (COVID-19) situation report–114 (13th May, 2020). https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200513-covid-19-sitrep-114.pdf?sfvrsn=17ebbbe_4. Accessed on 13 May 2020.
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5. LeBlanc JJ, Gubbay JB, Li Y, et al. COVID-19 Pandemic Diagnostics Investigation Team of the Canadian Public Health Laboratory Network (CPHLN) Respiratory Virus Working Group 2020. Real-time PCR-based SARS-CoV-2 detection in Canadian laboratories. J Clin Virol 128:104433.
6. O’Shea PM, Lee GR, Griffin TP, et al. COVID-19 in adults: test menu for hospital blood science laboratories. Ir J Med Sci 2020;189:1147–1152.
7. Stegeman I, Ochodo EA, Guleid F, et al. Routine laboratory testing to determine if a patient has COVID-19. Cochrane Database Syst Rev 2020;11:CD013787.
8. Sharma A, Farouk IA, Lal SK. COVID-19: A Review on the Novel Coronavirus Disease Evolution, Transmission, Detection, Control and Prevention. Viruses. 2021;13(2):202.
9. Feng JR, Qiu X, Wang F, et al. Diagnostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Crohn's Disease. Gastroenterol Res Pract. 2017;2017:3526460.
10. Cetin MS, Ozcan Cetin EH, Kalender E, et al. Monocyte to HDL Cholesterol Ratio Predicts Coronary Artery Disease Severity and Future Major Cardiovascular Adverse Events in Acute Coronary Syndrome. Heart Lung Circ. 2016;25(11):1077–86.
11. Marin Hernandez C, Pinero Madrona A, Gil Vazquez PJ, et al. Usefulness of lymphocyte-to-monocyte, neutrophil-to-monocyte and neutrophil-to-lymphocyte ratios as prognostic markers in breast cancer patients treated with neoadjuvant chemotherapy. Clin Transl Oncol. 2018;20(4):476-483.
12. Liu H, Zhan F, Wang Y. Evaluation of monocyte-to-high-density lipoprotein cholesterol ratio and monocyte-to-lymphocyte ratio in ischemic stroke. J Int Med Res. 2020;48(7):0300060520933806
13. Chen Y, Klein SL, Garibaldi BT, et al. Aging in COVID-19: Vulnerability, immunity and intervention. Ageing Res Rev. 2021;65:101205.
14. Hwang J, Ryu HS, Kim HA, et al. Prognostic Factors of COVID-19 Infection in Elderly Patients: A Multicenter Study. J Clin Med. 2020;9(12):3932.
15. Wang L, He W, Yu X, et al. Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;80(6):639–645.
16. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J. Clin. Invest. 2013;111:1805–12.
17. Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with CT findings and predicts severe COVID-19 early. J Med Virol. 2020;92(7):856-62.
18. Liu F, Li L, Xu M, et al. Prognostic value of interleukin-6, C- reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol 2020;127:104370.
19. Liu K, Chen Y, Lin R. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):e14–e18
20. Henry BM, Oliveira MHS, de Benoit S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58(7):1021-28
21. Paliogiannis P. Laboratory test alterations in patients with COVID-19 and non COVID-19 interstitial pneumonia: a preliminary report. The Journal of Infection in Developing Countries. 2020;14(07):685–90.
22. Andonegui-Elguera S. Molecular alterations prompted by SARS-CoV-2 infection: induction of hyaluronan, glycosaminoglycan and mucopolysaccharide metabolism. Arch. Med. Res. 2020;51:645–53.
23. Navab M, Reddy ST, Van Lenten BJ, et al. HDL and cardiovascular disease: atherogenic and atheroprotective mechanisms. Nat Rev Cardiol 2011;8:222-32.
24. Villanueva DLE, Tiongson MD, Ramos JD, et al. Monocyte to High-Density Lipoprotein Ratio (MHR) as a predictor of mortality and Major Adverse Cardiovascular Events (MACE) among ST Elevation Myocardial Infarction (STEMI) patients undergoing primary percutaneous coronary intervention: a meta-analysis. Lipids Health Dis. 2020;19:55.
25. Yang AP, Liu JP, Tao WQ, et al. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504.
26. Man MA, Rajnoveanu RM, Motoc NS, et al. Neutrophil-to-lymphocyte ratio, platelets-to-lymphocyte ratio, and eosinophils correlation with high-resolution computer tomography severity score in COVID-19 patients. Published: June 28, 2021. https://doi.org/10.1371/journal.pone.0252599
27. Tsang OY, Chau TN, Choi KW, et al. Coronavirus-positive nasopharyngeal aspirate as predictor for severe acute respiratory syndrome mortality. Emerg Infect Dis. 2003;9:1381–87.
28. Ahn S, Kim WY, Kim SH, et al. Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia. Influenza Other Respi Viruses. 2011;5:398–403.
29. Xiong Y, Sun D, Liu Y, et al. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Invest Radiol 2020;6:332–339.

Year 2022, , 323 - 329, 01.07.2022

Orkun Sarıçam , Gülhan Sarıçam

https://doi.org/10.31067/acusaglik.1019135

Abstract

Supporting Institution

yok

References

1. WHO. 2020. Coronavirus disease 2019 (COVID-19) situation report–114 (13th May, 2020). https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200513-covid-19-sitrep-114.pdf?sfvrsn=17ebbbe_4. Accessed on 13 May 2020.
2. Fehr A, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. Coronaviruses. 2015;1282:1–23. 3. Tali SHS, LeBlanc JJ, Sadiq Z, et al. Tools and Techniques for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) /COVID-19 Detection. Clin Microbiol Rev. 2021;34(3):e00228-20.
4. Han R, Huang L, Jiang H, et al. Early clinical and CT manifestations of coronavirus disease 2019 (COVID-19) pneumonia. AJR Am J Roentgenol. 2020;215(2):338-343.
5. LeBlanc JJ, Gubbay JB, Li Y, et al. COVID-19 Pandemic Diagnostics Investigation Team of the Canadian Public Health Laboratory Network (CPHLN) Respiratory Virus Working Group 2020. Real-time PCR-based SARS-CoV-2 detection in Canadian laboratories. J Clin Virol 128:104433.
6. O’Shea PM, Lee GR, Griffin TP, et al. COVID-19 in adults: test menu for hospital blood science laboratories. Ir J Med Sci 2020;189:1147–1152.
7. Stegeman I, Ochodo EA, Guleid F, et al. Routine laboratory testing to determine if a patient has COVID-19. Cochrane Database Syst Rev 2020;11:CD013787.
8. Sharma A, Farouk IA, Lal SK. COVID-19: A Review on the Novel Coronavirus Disease Evolution, Transmission, Detection, Control and Prevention. Viruses. 2021;13(2):202.
9. Feng JR, Qiu X, Wang F, et al. Diagnostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Crohn's Disease. Gastroenterol Res Pract. 2017;2017:3526460.
10. Cetin MS, Ozcan Cetin EH, Kalender E, et al. Monocyte to HDL Cholesterol Ratio Predicts Coronary Artery Disease Severity and Future Major Cardiovascular Adverse Events in Acute Coronary Syndrome. Heart Lung Circ. 2016;25(11):1077–86.
11. Marin Hernandez C, Pinero Madrona A, Gil Vazquez PJ, et al. Usefulness of lymphocyte-to-monocyte, neutrophil-to-monocyte and neutrophil-to-lymphocyte ratios as prognostic markers in breast cancer patients treated with neoadjuvant chemotherapy. Clin Transl Oncol. 2018;20(4):476-483.
12. Liu H, Zhan F, Wang Y. Evaluation of monocyte-to-high-density lipoprotein cholesterol ratio and monocyte-to-lymphocyte ratio in ischemic stroke. J Int Med Res. 2020;48(7):0300060520933806
13. Chen Y, Klein SL, Garibaldi BT, et al. Aging in COVID-19: Vulnerability, immunity and intervention. Ageing Res Rev. 2021;65:101205.
14. Hwang J, Ryu HS, Kim HA, et al. Prognostic Factors of COVID-19 Infection in Elderly Patients: A Multicenter Study. J Clin Med. 2020;9(12):3932.
15. Wang L, He W, Yu X, et al. Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;80(6):639–645.
16. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J. Clin. Invest. 2013;111:1805–12.
17. Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with CT findings and predicts severe COVID-19 early. J Med Virol. 2020;92(7):856-62.
18. Liu F, Li L, Xu M, et al. Prognostic value of interleukin-6, C- reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol 2020;127:104370.
19. Liu K, Chen Y, Lin R. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):e14–e18
20. Henry BM, Oliveira MHS, de Benoit S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58(7):1021-28
21. Paliogiannis P. Laboratory test alterations in patients with COVID-19 and non COVID-19 interstitial pneumonia: a preliminary report. The Journal of Infection in Developing Countries. 2020;14(07):685–90.
22. Andonegui-Elguera S. Molecular alterations prompted by SARS-CoV-2 infection: induction of hyaluronan, glycosaminoglycan and mucopolysaccharide metabolism. Arch. Med. Res. 2020;51:645–53.
23. Navab M, Reddy ST, Van Lenten BJ, et al. HDL and cardiovascular disease: atherogenic and atheroprotective mechanisms. Nat Rev Cardiol 2011;8:222-32.
24. Villanueva DLE, Tiongson MD, Ramos JD, et al. Monocyte to High-Density Lipoprotein Ratio (MHR) as a predictor of mortality and Major Adverse Cardiovascular Events (MACE) among ST Elevation Myocardial Infarction (STEMI) patients undergoing primary percutaneous coronary intervention: a meta-analysis. Lipids Health Dis. 2020;19:55.
25. Yang AP, Liu JP, Tao WQ, et al. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504.
26. Man MA, Rajnoveanu RM, Motoc NS, et al. Neutrophil-to-lymphocyte ratio, platelets-to-lymphocyte ratio, and eosinophils correlation with high-resolution computer tomography severity score in COVID-19 patients. Published: June 28, 2021. https://doi.org/10.1371/journal.pone.0252599
27. Tsang OY, Chau TN, Choi KW, et al. Coronavirus-positive nasopharyngeal aspirate as predictor for severe acute respiratory syndrome mortality. Emerg Infect Dis. 2003;9:1381–87.
28. Ahn S, Kim WY, Kim SH, et al. Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia. Influenza Other Respi Viruses. 2011;5:398–403.
29. Xiong Y, Sun D, Liu Y, et al. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Invest Radiol 2020;6:332–339.

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Details

Primary Language	English
Subjects	Clinical Sciences
Journal Section	Research Article
Authors	Orkun Sarıçam 0000-0001-5820-0951 Gülhan Sarıçam 0000-0002-9032-6877
Publication Date	July 1, 2022
Submission Date	November 4, 2021
Published in Issue	Year 2022

Cite

EndNote	Sarıçam O, Sarıçam G (July 1, 2022) COVID-19 in Geriatric Patients. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 13 3 323–329.

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