Background: Aim of the present study is to describe characteristics of COVID-19 related deaths and to compare the clinical phenotype and course of COVID-19 related deaths occurring in adults (< 65 years) and older adults (≥ 65 years). Methods: Medical charts of 3,032 patients dying with COVID-19 in Italy (368 aged < 65 years and 2,664 aged ≥ 65 years) were revised to extract information on demographics, pre-existing comorbidities, and in-hospital complications leading to death. Results: Older adults (≥ 65 years) presented with a higher number of comorbidities compared to those aged < 65 years (3.3 ± 1.9 vs. 2.5 ± 1.8, p<0.001). Prevalence of ischemic heart disease, atrial fibrillation, heart failure, stroke, hypertension, dementia, COPD, and chronic renal failure was higher in older patients (≥ 65 years), while obesity, chronic liver disease, and HIV infection were more common in younger adults (< 65 years); 10.9% of younger patients (< 65 years) had no comorbidities, compared to 3.2% of older patients (≥ 65 years). The younger adults had a higher rate of non-respiratory complications than older patients including acute renal failure (30.0% vs 20.6%), acute cardiac injury (13.5% vs 10.3%), and superinfections (30.9% vs. 9.8%). Conclusions: individuals dying with COVID-19 present with high levels of comorbidities, irrespective of age group, but a small proportion of deaths occurs in healthy adults with no pre-existing conditions. Non-respiratory complications are common, suggesting that the treatment of respiratory conditions needs to be combined with strategies to prevent and mitigate the effects of non-respiratory complications.

Clinical characteristics of hospitalized individuals dying with COVID-19 by Age Group in Italy / Palmieri, Luigi; Vanacore, Nicola; Donfrancesco, Chiara; Lo Noce, Cinzia; Canevelli, Marco; Punzo, Ornella; Raparelli, Valeria; Pezzotti, Patrizio; Riccardo, Flavia; Bella, Antonio; Fabiani, Massimo; D'Ancona, Fortunato Paolo; Vaianella, Luana; Tiple, Dorina; Colaizzo, Elisa; Palmer, Katie; Rezza, Giovanni; Piccioli, Andrea; Brusaferro, Silvio; Onder, Graziano; Italian National Institute of Health COVID-19 mortality, Group. - In: JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES. - ISSN 1079-5006. - (2020), pp. 1-5. [10.1093/gerona/glaa146]

Clinical characteristics of hospitalized individuals dying with COVID-19 by Age Group in Italy

Palmieri, Luigi;Vanacore, Nicola;Donfrancesco, Chiara;Canevelli, Marco;Punzo, Ornella;Raparelli, Valeria;Riccardo, Flavia;Fabiani, Massimo;Colaizzo, Elisa;Brusaferro, Silvio;Onder, Graziano
;
2020

Abstract

Background: Aim of the present study is to describe characteristics of COVID-19 related deaths and to compare the clinical phenotype and course of COVID-19 related deaths occurring in adults (< 65 years) and older adults (≥ 65 years). Methods: Medical charts of 3,032 patients dying with COVID-19 in Italy (368 aged < 65 years and 2,664 aged ≥ 65 years) were revised to extract information on demographics, pre-existing comorbidities, and in-hospital complications leading to death. Results: Older adults (≥ 65 years) presented with a higher number of comorbidities compared to those aged < 65 years (3.3 ± 1.9 vs. 2.5 ± 1.8, p<0.001). Prevalence of ischemic heart disease, atrial fibrillation, heart failure, stroke, hypertension, dementia, COPD, and chronic renal failure was higher in older patients (≥ 65 years), while obesity, chronic liver disease, and HIV infection were more common in younger adults (< 65 years); 10.9% of younger patients (< 65 years) had no comorbidities, compared to 3.2% of older patients (≥ 65 years). The younger adults had a higher rate of non-respiratory complications than older patients including acute renal failure (30.0% vs 20.6%), acute cardiac injury (13.5% vs 10.3%), and superinfections (30.9% vs. 9.8%). Conclusions: individuals dying with COVID-19 present with high levels of comorbidities, irrespective of age group, but a small proportion of deaths occurs in healthy adults with no pre-existing conditions. Non-respiratory complications are common, suggesting that the treatment of respiratory conditions needs to be combined with strategies to prevent and mitigate the effects of non-respiratory complications.
2020
covid-19; epidemiology; mortality
01 Pubblicazione su rivista::01a Articolo in rivista
Clinical characteristics of hospitalized individuals dying with COVID-19 by Age Group in Italy / Palmieri, Luigi; Vanacore, Nicola; Donfrancesco, Chiara; Lo Noce, Cinzia; Canevelli, Marco; Punzo, Ornella; Raparelli, Valeria; Pezzotti, Patrizio; Riccardo, Flavia; Bella, Antonio; Fabiani, Massimo; D'Ancona, Fortunato Paolo; Vaianella, Luana; Tiple, Dorina; Colaizzo, Elisa; Palmer, Katie; Rezza, Giovanni; Piccioli, Andrea; Brusaferro, Silvio; Onder, Graziano; Italian National Institute of Health COVID-19 mortality, Group. - In: JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES. - ISSN 1079-5006. - (2020), pp. 1-5. [10.1093/gerona/glaa146]
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