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Open Access 01-12-2021 | SARS-CoV-2 | Research

Age differences in the association of comorbid burden with adverse outcomes in SARS-CoV-2

Authors: A. M. O’Hare, K. Berry, V. S. Fan, K. Crothers, M. C. Eastment, J. A. Dominitz, J. A. Shah, P. Green, E. Locke, G. N. Ioannou

Published in: BMC Geriatrics | Issue 1/2021

Abstract

Background

Older age and comorbid burden are both associated with adverse outcomes in SARS-CoV-2, but it is not known whether the association between comorbid burden and adverse outcomes differs in older and younger adults.

Objective

To compare the relationship between comorbid burden and adverse outcomes in adults with SARS-CoV-2 of different ages (18–64, 65–79 and ≥ 80 years).

Design, setting, and participants

Observational longitudinal cohort study of 170,528 patients who tested positive for SARS-CoV-2 in the US Department of Veterans Affairs (VA) Health Care System between 2/28/20 and 12/31/2020 who were followed through 01/31/2021.

Measurements

Charlson Comorbidity Index (CCI); Incidence of hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death within 30 days of a positive SARS-CoV-2 test.

Results

The cumulative 30-day incidence of death was 0.8% in cohort members < 65 years, 7.1% in those aged 65–79 years and 20.6% in those aged ≥80 years. The respective 30-day incidences of hospitalization were 8.2, 21.7 and 29.5%, of ICU admission were 2.7, 8.6, and 11% and of mechanical ventilation were 1, 3.9 and 3.2%. Median CCI (interquartile range) ranged from 0.0 (0.0, 2.0) in the youngest, to 4 (2.0, 7.0) in the oldest age group. The adjusted association of CCI with all outcomes was attenuated at older ages such that the threshold level of CCI above which the risk for each outcome exceeded the reference group (1st quartile) was lower in younger than in older cohort members (p < 0.001 for all age group interactions).

Limitations

The CCI is calculated based on diagnostic codes, which may not provide an accurate assessment of comorbid burden.

Conclusions

Age differences in the distribution and prognostic significance of overall comorbid burden could inform clinical management, vaccination prioritization and population health during the pandemic and argue for more work to understand the role of age and comorbidity in shaping the care of hospitalized patients with SARS-CoV-2.

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Title: Age differences in the association of comorbid burden with adverse outcomes in SARS-CoV-2
Authors: A. M. O’Hare
K. Berry
V. S. Fan
K. Crothers
M. C. Eastment
J. A. Dominitz
J. A. Shah
P. Green
E. Locke
G. N. Ioannou
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: SARS-CoV-2
Published in: BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-021-02340-5

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Abstract

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Design, setting, and participants

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Results

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Other articles of this Issue 1/2021

Association between hearing loss and frailty: a systematic review and meta-analysis

Positive and negative ageing perceptions account for health differences between older immigrant and native populations in the Netherlands

How cognitive loads modulate the postural control of older women with low back pain?

Impact of the COVID-19 pandemic on symptoms of anxiety and depression and health-related quality of life in older patients with chronic kidney disease

The Frailty In Residential Sector over Time (FIRST) study: methods and baseline cohort description

Correction to: Socially desirable responding in geriatric outpatients with and without mild cognitive impairment and its association with the assessment of self-reported mental health

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