COVID-19 in persons aged 70+ in an early affected German district: Risk factors, mortality and post-COVID care needs-A retrospective observational study of hospitalized and non-hospitalized patients

Cohorts of hospitalized COVID-19 patients have been studied in several countries since the beginning of the pandemic. So far, there is no complete survey of older patients in a German district that includes both outpatients and inpatients. In this retrospective observational cohort study, we aimed t...

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Bibliographic Details
Published in:	PloS one Vol. 16; no. 6; p. e0253154
Main Authors:	Herrmann, Matthias L, Hahn, Johannes-Martin, Walter-Frank, Birgit, Bollinger, Desiree M, Schmauder, Kristina, Schnauder, Günter, Bitzer, Michael, Malek, Nisar P, Eschweiler, Gerhard W, Göpel, Siri
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 18-06-2021 Public Library of Science (PLoS)
Subjects:	Age Aged Aged, 80 and over Biology and Life Sciences Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 - virology Data Collection - methods Data Collection - statistics & numerical data Dementia Female Geriatric nursing Geriatrics Germany - epidemiology Health risks Hospital patients Hospitalization Hospitalization - statistics & numerical data Hospitals Humans Influenza Informed consent Inpatients - statistics & numerical data Intensive care Internal medicine Male Medical records Medicine Medicine and Health Sciences Mortality Nursing homes Nursing Homes - statistics & numerical data Observational studies Olfaction Outpatients - statistics & numerical data Pandemics Patient outcomes People and places Prevalence Psychotherapy Public health Retrospective Studies Risk analysis Risk Factors SARS-CoV-2 - isolation & purification SARS-CoV-2 - physiology Severe acute respiratory syndrome coronavirus 2 Smell Ventilators Germany
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Summary:	Cohorts of hospitalized COVID-19 patients have been studied in several countries since the beginning of the pandemic. So far, there is no complete survey of older patients in a German district that includes both outpatients and inpatients. In this retrospective observational cohort study, we aimed to investigate risk factors, mortality, and functional outcomes of all patients with COVID-19 aged 70 and older living in the district of Tübingen in the southwest of Germany. We retrospectively analysed all 256 patients who tested positive for SARS-CoV-2 in one of the earliest affected German districts during the first wave of the disease from February to April 2020. To ensure inclusion of all infected patients, we analysed reported data from the public health department as well as the results of a comprehensive screening intervention in all nursing homes of the district (n = 1169). Furthermore, we examined clinical data of all hospitalized patients with COVID-19 (n = 109). The all-cause mortality was 18%. Screening in nursing homes showed a point-prevalence of 4.6%. 39% of residents showed no COVID-specific symptoms according to the official definition at that time. The most important predictors of mortality were the need for inpatient treatment (odds ratio (OR): 3.95 [95%-confidence interval (CI): 2.00-7.86], p<0.001) and care needs before infection (non-hospitalized patients: OR: 3.79 [95%-CI: 1.01-14.27], p = 0.037, hospitalized patients: OR: 2.89 [95%-CI 1.21-6.92], p = 0.015). Newly emerged care needs were a relevant complication of COVID-19: 27% of previously self-sufficient patients who survived the disease were not able to return to their home environment after discharge from the hospital. Our findings demonstrate the importance of a differentiated view of risk groups and long-term effects within the older population. These findings should be included in the political and social debate during the ongoing pandemic to evaluate the true effect of COVID-19 on healthcare systems and individual functional status.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0253154