Clinical profile and outcome of elderly COVID-19 patients
Keywords:COVID-19, Neutrophil lymphocyte ratio, D-dimer
Background: Emerging and reemerging infectious disease have plagued mankind and have been potential killer since historic times. The current pandemic of COVID-19 is the latest crisis that has challenged leadership and health infrastructure globally. Since, elderly are more susceptible, understanding risk factor and clinical feature in them is critically important to improve the outcome and efficacy of treatment.
Methods: The prospective study included 1187 patients, aged ≥65 years diagnosed with COVID-19. Necessary record like demographic data, comorbidities and clinical features were collected. Relevant laboratory investigation done. Patients were grouped as survival and death. Different parameters were compared using t-test for continuous variables and Chi-square test for categorical data. Receiver operating curve (ROC) drawn using SPSS software.
Results: Out of 1187 elderly people,316 (26%) have succumbed to death. Mortality was more in Male (68.7%). Fever (42%), cough (33.2%), dyspnea (26.9%) were the major symptom. Among patient who succumbed to death 45.9% people had diabetes with hypertension, 15.2% had only diabetes, 17.1% had only hypertension, 12.3% had chronic kidney disease and 15.56% had IHD. ROC curve drawn for TLC (AUC=0.72), NLR ratio (AUC=0.844), LDH (AUC=0.842), D-dimer (AUC=0.851), CRP (AUC=0.82), ferritin (AUC=0.823) which were statistically significant as predictor of disease outcome. D-dimer at cut-off 1 mcg/ml has specificity 89% and sensitivity 76% which is highest among the parameter, followed by NLR ratio at 6.9 has specificity (82%), sensitivity (73%).
Conclusions: D-dimer of 1 mcg/ml, NLR ratio of 6.9 may assist in triaging patient requiring ICU care and deciding intervention. Also, elderly with multiple comorbidity should be treated aggressively, so that chance of survival can be increased.
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