The impact of age and underlying comorbidities on the course of COVID-19 disease; First three months data of pandemic from Antalya, Turkey

Öz

Aim: This study aimed to evaluate the demographic characteristics, clinical course, treatment, and outcome data of COVID-19 patients confirmed by laboratory tests in Antalya province according to age and the presence of comorbid diseases. Methods: This retrospective, cross-sectional study included 438 patients diagnosed with COVID-19 as confirmed by PCR tests in Antalya between March 16th and June 15th, 2020. The study continued with 311 patients after exclusion of patients under the age of 18 as well as those with incomplete data and those receiving health care at private hospitals. The patients were divided into groups according to being under 65 years of age, with or without underlying comorbidities, with or without intensive care unit (ICU) admission, and were compared in terms of demographic characteristics, clinical course, treatment, and outcomes. Results: The study included 311 patients diagnosed with COVID-19 as confirmed by SARS-CoV-2 RT-PCR tests. The mean age was 47.48 ± 18.08 (min: 18, max: 94) years and 252 patients (81%) were under 65, while 52 patients (19%) were 65 and over years of age. Forty-five percent of the patients were women and 55% were men. Comorbidity, namely, hypertension (p<0.001), diabetes mellitus (p=0.010), chronic pulmonary diseases (p=0.001), and cardiovascular diseases (p<0.001) were significantly more common in geriatric patients compared to non-geriatric patients. Patients aged 65 and over, and patients with underlying comorbidities had significantly increased dyspnea, positive chest CT findings, ICU admission, mortality rates and hospitalization time compared to patients under 65 years of age and without comorbidities, respectively. Oseltamivir, favipiravir and levofloxacin were used significantly more in the treatment of geriatric patients and patients with underlying comorbidities. Being 65 and older was determined as a risk factor in univariate and multivariate models for both ICU admission and mortality. Conclusion: As a result, the need for intensive care and mortality rates have increased in COVID-19 patients who are older and/or have underlying comorbidities, indicating the necessity to take measures for preventing the spread of SARS-CoV-2, especially to patients who are older and/or have underlying comorbidities.

Anahtar Kelimeler

• comorbidities
• coronavirus
• geriatrics

COVID-19 hastalığı seyrine yaş ve komorbid durumların etkisi; Antalya’dan pandemi ilk üç ay verileri

Öz

Amaç: Bu araştırmada; Antalya ilinde laboratuvar testleri ile konfirme edilmiş COVID-19 hastalarının demografik özelliklerinin, klinik seyirlerinin, tedavi ve sonuç verilerinin yaşa ve komorbid hastalıkların varlığına göre değerlendirilmesi amaçlanmıştır. Yöntem: Retrospektif, tanımlayıcı çalışmaya 16.03.2020 tarihi ile 15.06.2020 tarihleri arasında Antalya ilinde revers transkritaz polimeraz zincir reaksiyonu yöntemi ile COVID-19 tanısı konan 438 hasta dahil edildi. On sekiz yaş altında olan, eksik verileri olan ve özel hastanelerden hizmet alan hastalar çalışma dışı bırakıldıktan sonra 311 hasta ile çalışmaya devam edildi. Hastalar 65 yaş altı ve 65 yaş ve üzeri, kronik hastalıkları olan ve olmayan, yoğun bakım ünitesine yatışı olan ve olmayan şeklinde gruplara ayrılarak demografik özellikleri, klinik seyirleri, tedavi ve sonuç çıktıları açısından karşılaştırıldı. Bulgular: Çalışmaya SARS-CoV-2 revers transkritaz polimeraz zincir reaksiyonu yöntemi ile COVID-19 tanısı alan 311 hasta dahil edildi. Yaş ortalaması 47,48±18,08 (min: 18, maks: 94) yıldı ve 252 hasta (%81) 65 yaş altında, 52 hasta (%19) 65 yaş ve üzerindeydi. Hastaların %45’i kadın, %55’i erkekti. Geriatrik hastalarda non-geriatrik hastalara göre komorbid hastalıklar; hipertansiyon (p<0,001), diabetes mellitus (p=0,010), kronik akciğer hastalıkları (p=0,001) ve kardiyovasküler hastalıklar (p<0,001) anlamlı düzeyde daha sık görülmekteydi. Altmış beş ve üzeri yaş hastalar ile komorbiditesi olan hastalarda sırasıyla <65 yaş ve komorbiditesi olmayan hastalara göre dispne, pozitif akciğer bilgisayarlı tomografi bulguları, yoğun bakım ünitesinde yatış, mortalite oranları ve hastanede yatış süreleri anlamlı düzeyde artmıştı. Geriatrik hastalar ile komorbiditesi olan hastaların tedavisinde oseltamivir, favipiravir, levofloksasin anlamlı olarak daha çok kullanılmıştı. Altmış beş ve üzeri yaşta olmak hem yoğun bakım ünitesine yatış hem de mortalite için risk faktörü olarak tespit edildi. Sonuç: Sonuç olarak; 65 ve üzeri yaşta ve/veya komorbiditesi olan COVID-19 hastalarında yoğun bakım ihtiyacı ve mortalite artmaktadır. SARS-CoV-2’nin özellikle bu hasta grubuna yayılmasını önlemeye yönelik tedbirlerin alınması gerektiği açıktır.

Anahtar Kelimeler

• geriatrik hastalar
• coronavirus
• komorbiditeler

Kaynakça

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