Predictors of Clinical Outcomes in Elderly  COVID-19 Patients Admitted to a Tertiary  Care Hospital in Tamil Nadu: An Analytical  Retrospective Study

Madan  Gunasekaran; Anusha Ben Elizabeth; Merlin Shalini Ruth S

Madan Gunasekaran Junior Resident, Department of Anaesthesiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education.
Anusha Ben Elizabeth Junior Resident, Department of Anaesthesiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education.
Merlin Shalini Ruth S Professor, Department of Anaesthesiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education.

Keywords: Elderly, COVID-ICU, Acute Kidney Injury, Hypertension

Abstract

Background: Understanding the factors leading to mortality in the elderly population would help in warning the patients with risk factors to be cautious and in informing the policymakers of any required changes in policies.

Methods: This retrospective, analytical study included 133 elderly patients with laboratory-confirmed SARS-CoV-2 infection requiring oxygen support or ICU admission during the period of May-Dec 2020. Data including age, gender, comorbidities, oxygen support requirement and level of its escalation, HRCT severity score, laboratory findings, and duration of stay were collected and analysed to find the predictors that influence the outcome of death.

Results: Univariate Cox analysis showed that hypertensive patients had a hazard ratio of 0.52 (CI: 0.32-0.85, p = 0.009) and those with acute kidney injury had a hazard ratio of 2.50 (CI: 1.46-4.29, p = 0.001). Patients with severe CT severity scores had 3.23 times higher risk of death than patients with moderate CT severity scores. Positive procalcitonin showed a higher hazard ratio of 1.72 (CI: 1.02-2.88) while the hazard ratios for elevated CRP levels, D-dimer, LDH, troponin I, and IL-6 were lower yet significant with the values being: 1.004 (CI: 1.000-1.007), 1.0002 (CI: 1.0000-1.0003), 1.002 (CI: 1.001-1.004), 1.0001 (CI: 1.0000-1.0001), and 1.0007 (CI: 1.000-1.001) respectively.

Cox multivariate regression analysis reported hypertension (HR: 0.22, CI: 0.08-0.58), presence of AKI (HR: 3.97, CI: 1.12-14.08), and higher serum troponin values (HR: 1.00, CI: 1.0000-1.0003) to be significantly associated with an increased risk of death.

Conclusion: Our study showed that the presence of acute kidney injury at the time of admission to COVID-ICU was associated with a poor outcome. Hypertensive patients had better outcomes.

How to cite this article:
Gunasekaran M, Elizabeth AB, Merlin Shalini Ruth S. Predictors of Clinical Outcomes in Elderly COVID-19 Patients Admitted to a Tertiary Care Hospital in Tamil Nadu: An Analytical Retrospective Study. J Commun Dis.
2023;55(2):39-47.

DOI: https://doi.org/10.24321/0019.5138.202323

Author Biographies

Anusha Ben Elizabeth, Junior Resident, Department of Anaesthesiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education.

Junior resident

Merlin Shalini Ruth S, Professor, Department of Anaesthesiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education.

Professor,Department of Anaesthesiology

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