In-hospital mortality of older patients with COVID-19 throughout the epidemic waves in the great Paris area: a multicenter cohort study

被引：6

作者：

Thietart, Sara ^{[1
]}

Rozes, Antoine ^{[2
]}

Tubach, Florence ^{[3
]}

Marot, Stephane ^{[4
]}

Marcelin, Anne-Genevieve ^{[4
]}

Raux, Mathieu ^{[5
]}

Vallet, Helene ^{[6
]}

Riou, Bruno ^{[7
]}

Boddaert, Jacques ^{[8
]}

Zerah, Lorene ^{[9
]}

机构：

[1] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, Dept Geriatrie, Paris, France

[2] Hop La Pitie Salpetriere, AP HP, Ctr Pharmacoepidemiol Cephepi, Unite Rech Clin PSL,CFX,CIC 1901, F-75013 Paris, France

[3] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, Inst Pierre Louis Epidemiol & Sante Publ,CIC 1901,, F-75013 Paris, France

[4] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, Inst Pierre Louis Epidemiol & Sante Publ,INSERM,De, Paris, France

[5] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, INSERM,UMRS1158,Dept Anesthesie Reanimat, Paris, France

[6] Sorbonne Univ, Hop St Antoine, AP HP, Dept Geriatrie,INSERM,Ctr Immunol & Malad Infectie, Paris, France

[7] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, INSERM,UMRS 1166,Dept Urgences,IHU ICAN, Paris, France

[8] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, Ctr Immunol & Malad Infectieuses Cimi Paris,INSERM, Paris, France

[9] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, Inst Pierre Louis Epidemiol & Sante Publ,INSERM,De, Paris, France

来源：

BMC GERIATRICS | 2023年 / 23卷 / 01期

关键词：

COVID-19; In-hospital mortality; Geriatric; Waves; Omicron; SEVERITY;

D O I：

10.1186/s12877-023-04236-y

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

BackgroundMortality is high in older patients hospitalized with COVID-19. Previous studies observed lower mortality during the Omicron wave, yet no data is available on older patients. The objective was to compare in-hospital mortality between the Omicron and previous waves in older patients hospitalized with COVID-19.MethodsThis retrospective observational multicenter cohort study used the Greater Paris University Hospitals Group's data warehouse (38 hospitals). Patients aged & GE; 75 years with a confirmed COVID-19 diagnosis and hospitalized from March 2020 to January 2022 were included. The study period was divided into five waves. The fifth wave (January 1st to 31st 2022) was considered as the Omicron wave as it was the predominant variant (& GE; 50%), and was compared with waves 1 (March-July 2020), 2 (August-December 2020), 3 (January-June 2021) and 4 (July-December 2021). Primary outcome was in-hospital mortality. Secondary outcome was occurrence of ICU admission or in-hospital death. Multivariate logistic regression was performed, with a sensitivity analysis according to variant type.ResultsOf the 195,084 patients hospitalized with COVID-19, 19,909 patients aged & GE; 75 years were included (median age 85 [IQR 79-90] years, 53% women). Overall in-hospital mortality was 4,337 (22%), reaching 345 (17%) during wave 5. Waves 1 and 3 were significantly associated with increased in-hospital mortality in comparison with wave 5 (adjusted Odds Ratios aOR 1.42 [95%CI 1.21-1.66] and 1.56 [95%CI 1.33-1.83] respectively). Waves 1 to 3 were associated with an increased risk of occurrence of ICU admission or in-hospital death in comparison with wave 5: aOR 1.29 [95% CI 1.12 to 1.49] for wave 1, aOR 1.25 [95% CI 1.08 to 1.45] for wave 2 and aOR 1.56 [95% CI 1.36 to 1.79] for wave 3. Sensitivity analysis found that Omicron variant was associated with decreased mortality, in comparison with previous variants.ConclusionsMortality was lower during the 5th Omicron wave in the older population, but remained high, implying that this variant could be considered as "milder" but not "mild". This persistently high mortality during the 5th Omicron wave highlights the importance of including older patients in clinical trials to confirm the benefit/risk balance of COVID-19 treatments in this fragile population.

引用

页数：10

共 31 条

[1] Severity of SARS-CoV-2 Reinfections as Compared with Primary Infections [J].