Predictors of survival in older adults hospitalized with COVID-19

Objective This study was designed to investigate clinical characteristics associated with mortality and predictors of survival in older adults hospitalized with COVID-19 with a focus on neurological comorbidities and presenting neurological manifestations. Methods We compared clinical characteristics in an age- and gender-matched sample of 75 deceased and 75 recovered patients (M-Age = 78) hospitalized with COVID-19 and developed a logistic regression to predict likelihood of survival. Results Deceased patients were more like to have dementia, altered mental status (AMS), acute respiratory distress syndrome (ARDS), sepsis, mechanical ventilation, and balance difficulties; higher heart rate, respiratory rate, blood urea nitrogen, creatinine, and absolute neutrophils; lower oxygen saturation and absolute lymphocytes; and shorter length of hospitalization. Logistic regression based on three mortality predictors (ARDS, AMS, and length of hospitalization) correctly predicted 87% of the outcome (89% sensitivity at 85% specificity). Conclusions Dementia and AMS were strong predictors of death in older adults hospitalized with COVID-19. Our findings add to the rapidly growing neurology of COVID-19 literature and underscore the importance of early recognition and the incorporation of a mental status examination into the medical assessment of COVID-19.

Automated summary

Our study found that patients with dementia and altered mental status are more likely to die in older adults hospitalized with COVID-19, highlighting the importance of early recognition and mental status assessment in the medical evaluation of COVID-19.