ArticleEinstein (Sao Paulo, Brazil)2025
Elderly patients in crisis: unveiling outcomes and management approaches in severe COVID-19 cases - a retrospective analysis from Brazil.
Article in Einstein (Sao Paulo, Brazil), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo analyze the sociodemographic and clinical characteristics, comorbidities, therapeutic resources, and mortality rates of elderly patients with COVID-19 admitted to an intensive care unit.
methodsThis retrospective cohort study included patients admitted to the intensive care unit of a large hospital in São Paulo, Brazil, from March 1, 2020, to March 31, 2021. Patients were categorized as adults (≥18 years) and elderly (≥60 years).
resultsOf the 504 patients, 326 (64.7%) were elderly. Compared to the adults, elderly patients had significantly higher Simplified Acute Physiology Score 3 and Sequential Organ Failure Assessment scores on admission (p<0.001). They also had a greater prevalence of comorbidities, as reflected by a higher Charlson Comorbidity Index (p<0.001) and were frailer according to the Modified Frailty Index (p<0.001). The elderly group had a longer intensive care unit stay, with an average of 17±19 days and a hospital stay of 40±39 days, compared to the adults who had an average intensive care unit stay of 14±16 days and a hospital stay of 28±25 days. Hospital mortality was significantly higher among elderly patients (37.7%) than among adults (12.4%) (p<0.001), especially in those who developed acute kidney injury and required vasopressors and extracorporeal membrane oxygenation. The other independent risk factors for mortality were frailty, arrhythmias, and prior organ transplantation.
conclusionFrail elderly intensive care unit patients with multiple comorbidities require more resources, have longer hospital stays, and face higher mortality rates. Early interventions targeting this population could improve survival.
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