Mortality Predictors Among COVID-19 Elderly in Taif, Saudi Arabia

Abstract

Background

By December 2021, the COVID-19 pandemic had caused more than 266 million cases and 5 million deaths, especially among geriatric patients.

Objective

To identify determinants of COVID-19-related death in geriatric patients.

Methods

This is a comparative retrospective study involving 145 COVID-19 hospitalized patients who are more than 60 years old, conducted at King Faisal Medical Complex in Taif, Saudi Arabia, from June 2020 to August 2020. The main outcome studied was COVID-19-related death.

Results

Out of 145 elderly COVID-19 patients, 11% have died. There was a significant difference between those who died and the surviving group regarding hospital stay duration, with a higher duration median among those who died (22 days vs 12 day respectively, p=0.002). Transfer to ICU, mechanical ventilation, low oxygen saturation, shortness of breath, respiratory support, x-ray trend, and prolonged QT interval showed significant statistical differences between them (p<0.001, <0.001, 0.017, 0.045, <0.001, <0.001, 0.004, respectively). After doing logistic regression of predictors for progression to death, putting patients on oxygen only vs mechanical ventilation was statistically significant, with an adjusted odds ratio (AOR) of 0.038 (p=0.012). Worse x-rays vs constant also were statistically significant and had AOR of 23.459 (p=0.001). There was a significant moderate positive correlation between duration of hospital stay and duration from admission to medication start (SP=0.336 and p<0.001).

Conclusion

We recommend accurately monitoring patients using x-rays to determine which patients have worse x-rays. However, the cost–benefit of using radiation must be well assessed and needs further research to determine if its benefit outweighs its risks, especially in high-risk patients. Furthermore, mechanically ventilated patients must be carefully monitored. Finally, the duration of hospital stay was highly correlated with the duration from admission to medication start. Therefore, proper treatment must be started as early as possible.

Keywords:

• COVID-19
• mortality
• elderly
• ICU

Institutional Review Board Statement

The study was conducted according to the guidelines of the bioethics and research committee of the King Faisal Medical Complex, Taif, Saudi Arabia, and approved by Taif Research and Ethics Committee (Approval # HAP- 02-T-67) under the reference number of (Reference Approval # HAP-02-T-67). As there is a cooperation between the Saudi Arabia ministry of higher education and the ministry of health, the research proposal was submitted to the health affair in Taif. Since the research idea was about psychiatric disease, the health affair in Taif directed the research to Mental Health Hospital in Taif.

Informed Consent Statement

This study was a comparative retrospective cohort study. At hospital admission, patients’ consents were taken to use their data with complete confidentiality. This study was compliant with the Declaration of Helsinki. Confidentiality was respected and data was not used for any other purpose.

Disclosure

The authors declare no conflicts of interest in this work.