Severity of COVID-19 in hospitalized elderly at admission, delay in hospitalization, and death from COVID-19

Background: Age is a strong risk factor for increasing the risk of severity and death from Covid-19. The risk of hospitalization for Covid-19 disease increases with age. Since the elderly constitute a large proportion of Covid-19 patients, the present study was performed to evaluate the severity of the disease in the hospitalized elderly due to Covid-19 and the delay in hospitalization and death resulting from it, for better disease management. Methods: The present retrospective cohort study was performed on 444 elderly patients with Covid-19 admitted from 1 April until late October 2020 in Baharloo Hospital in Tehran, Iran. After being diagnosed using the results of RT-PCR and CT scan, patients, were divided into 3 groups: moderate, severe and very severe based on the severity of the disease. Analysis of variance was used to compare quantitative data and a chi-square test was used to examine qualitative variables in disease groups. Results: From 444 elderly participants in the study, 73% were infected moderately, 15% severely, and 12% had a very severe form. The mean age was 72.90±8.42 and patients with a very severe form of the disease (75.68±8.28) were older. The average time from the onset of symptoms to hospitalization was 7 days. In the elderly with a very severe form of the disease, respiratory dyspnea (P=0.002) and decreased level of consciousness (P<0.0001) were higher. The average hospital stay was 7 days. In very severe form it lasted up to 11 days. ICU mortality and hospitalization were higher in patients with very severe forms of the disease. With the increasing delay in the days of hospitalization, the severity of the disease and mortality has increased. Conclusion: The study showed that prolonging the onset of symptoms till hospitalization worsens prognosis and also exacerbates the disease and increases mortality in the elderly.