Risk Factors for Mortality in 244 Older Adults With COVID-19 in Wuhan, China

A Retrospective Study

Haiying Sun, MD; Ruoqi Ning, MD; Yu Tao, MD; Chong Yu, MD; Xiaoyan Deng, MD; Caili Zhao, MM; Silu Meng, MM; Fangxu Tang, MD; Dong Xu, MD, PhD

Disclosures

J Am Geriatr Soc. 2020;68(6):E19-E23. 

In This Article

Methods

Participants

Participants were identified from inpatients of the Sino-French New City Branch of Tongji Hospital, a specialized hospital with 23 critical illness wards (including two intensive care units) with 1,085 beds for treating COVID-19, by searching the hospital's electronic medical records between January 29 and March 5, 2020. Patients aged 60 years or older, who were diagnosed with COVID-19 with definite outcomes (discharged or died in hospital) by March 5, 2020, were enrolled. The diagnosis of all included patients was confirmed according to the Diagnosis and Treatment Guideline for COVID-19 published by the National Health Commission of People's Republic of China.[5] Patients who died of COVID-19 and related complications in the hospital were enrolled as the deceased group, while those who fulfilled the criteria for cure of COVID-19, as per the guideline,[5] and were discharged from hospital were enrolled as the discharged group. This study was approved by the Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.

Data Collection

Demographic information and data regarding symptoms, signs, and laboratory findings on admission and outcomes were retrieved from electronic medical records and retrospectively reviewed and analyzed. At least two experienced researchers were responsible for data collection, and a trained team of physicians reviewed and analyzed data from each patient. The date of disease onset was defined as the day of the first self-reported onset of symptoms. Peripheral oxygen saturation (SpO2) was measured in the patient's oxygen-absorbing state because all patients were severely ill on admission or transferred from the fever clinic or other medical institutions with oxygen devices.

Statistical Analysis

Data are expressed as median (interquartile range) for continuous variables and counts and frequency (number [percentage]) for categorical variables. Comparison of categorical variables between the discharged and deceased groups was performed using Pearson's χ 2 test with continuity correction or Fisher's exact test, where appropriate. The Mann-Whitney U test was used to compare differences in continuous variables between the two groups because they were all nonnormally distributed. Multivariable logistic regression modeling and receiver operating characteristic (ROC) curves were used to explore independent risk factors for death. Continuous variables were treated as continuous measures in the model. The same univariate statistical methods were applied to compare differences between male and female patients, and to explore risk factors for mortality stratified according to sex. Statistical analyses were performed using SPSS version 21.0 (IBM Corporation). Differences were considered to be statistically significant when two-sided P values were < .05.

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