Characteristics, management and mortality of elderly patients with COVID-19 in intensive care at Hospital de Clínicas. San Lorenzo, Paraguay

Age and the presence of comorbidities were associated with a higher risk of complications and death related to COVID-19. In this group, mostly acute respiratory distress syndrome was observed requiring mechanical ventilation and unfavorable outcome. Patients and methods We performed an observational, retrospective, cross-sectional study with an analytical component. Patients >60 years of age with COVID-19 were included, variables studied: sociodemographic, comorbidities, severity scores, days of hospitalization, oxygenation status, oxygen therapy used, laboratory data and complications. The variables that were significant in the bivariate analysis, were included in the multivariate analysis by logistic regression. Those with a significance level p < 0.05 were taken into account. Results 274 patients with SARS CoV-2 pneumonia were admitted during the study period. 75 patients older than 60 years (35%) were included. The variables studied are presented in Table 1. The mortality found in our study was 52%. They were significative associated factors of mortality as the presence of heart disease [89.1%; OR 0.032(1069.76,334), p = 0.018], APACHE II score greater than 12 [71.7%, OR 9.73 (3.22–29.33), p < 0.001] and initial SOFA greater than 5 [84.8%, OR 15.78 (4.87–51.06), p < 0.001], PaO2/FiO2 less than 150 mmHg (92,3%, p = 0.002), the need for mechanical ventilation [76.6%, OR 86.36 (10,487-711,223), p < 0.001], pronation (67.4%, p < 0.001), the use of vasopressors [86%, 92,500 (17,392-491,956), p < 0.001] and hemodialysis requirement [87.5%, OR 7656 (0.892–65,690),). p = 0.033]. A lower risk of death was observed with the use of Tocilizumab [25%, OR 0.25 (0.062–1.012), p = 0.041] and Remdesivir [38.7%, OR 0.352 (0.135–0.915), p = 0.030]. In the multivariate study, the only independent mortality factor found was the use of vasopressors. Conclusion The mortality of elderly patients with COVID-19 was high, but similar to other studies in the region. In a bivariate study, pre-existing cardiovascular conditions, severity of the disease on admission, low oxygenation, the need for mechanical ventilation, pronation, the use of vasopressors, and the need for hemodialysis are related to increased mortality risks. Only the use of vasopressors persisted as an independent risk factor for mortality.