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Research Paper|Volume 12, Issue 12|pp 11306—11313

ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month mortality in older inpatients with Covid-19

Guilhem Bousquet1,2, Géraldine Falgarone2,3, David Deutsch4,5, Sophie Derolez4,6, Marilucy Lopez-Sublet7, François-Xavier Goudot8, Khadaoudj Amari9, Yurdagul Uzunhan10,11, Olivier Bouchaud12,13, Frédéric Pamoukdjian2,9
  • 1AP-HP Hôpital Avicenne, Oncologie Médicale, Bobigny 93000, France
  • 2Université Sorbonne Paris Nord, INSERM, U942, Cardiovascular Markers in Stressed Conditions, MASCOT, Bobigny 93000, France
  • 3AP-HP Hôpital Avicenne, Unité de Médecine Ambulatoire (UMA), Bobigny 93000, France
  • 4Université Sorbonne Paris Nord, Villetaneuse 93430, France
  • 5AP-HP Hôpital Avicenne, Gastroentérologie et Oncologie Digestive, Bobigny 93000, France
  • 6AP-HP Hôpital Avicenne, Rhumatologie, Bobigny 93000, France
  • 7AP-HP Hôpital Avicenne, Médecine Interne, ESH Hypertension Excellence Centre, Bobigny 93000, France
  • 8AP-HP Hôpital Avicenne, Cardiologie, Bobigny 93000, France
  • 9APHP Hôpital Avicenne, Service de Médecine Gériatrique, Bobigny 93000, France
  • 10AP-HP Hôpital Avicenne, Pneumologie, Bobigny 93000, France
  • 11Université Sorbonne Paris Nord, INSERM, U1272, Hypoxia and Lung, Bobigny 93000, France
  • 12AP-HP Hôpital Avicenne, Infectious Diseases, Bobigny 93000, France
  • 13EA 3412, Laboratoire Educations et Pratiques de Santé, Bobigny 93000, France
* Equal contribution
# Co-senior author
Received: May 12, 2020Accepted: June 12, 2020Published: June 23, 2020
https://doi.org/10.18632/aging.103583

Copyright © 2020 Bousquet et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: To assess factors associated with one-month mortality among older inpatients with Covid-19.

Results: The mean age was 78 ± 7.8 years, 55.5% were men, CT scan lung damage was observed in 76% of the patients (mild 23%, moderate 38%, extensive 22%, and severe 7%). The mortality rate was 26%. Dependency/Activities of Daily Living (ADL) score ≤ 5/6, D-Dimers, LDH, and no anticoagulation by reference for curative were independently associated with one-month mortality. A score derived from the multivariate model showed good calibration and very good discrimination (Harrell’s C index [95%CI] = 0.83 [0.79-0.87]).

Conclusion: ADL-dependency, high serum levels of D-Dimers and LDH and the absence of anticoagulation were independently associated with one-month mortality among older inpatients with Covid-19.

Methods: 108 consecutive older inpatients aged 65 and over with Covid-19 confirmed by RT-PCR and/or typical CT chest scan were prospectively included in a French single-centre cohort study from March to April 2020. A systematic geriatric assessment was performed. Covariates were lymphocyte count, serum levels of albumin, C-Reactive Protein, D-Dimers and Lactate Dehydrogenase (LDH), anticoagulation level, and exposure to the hydroxychloroquine and azithromycin combined therapy. Cox uni- and multivariate proportional-hazard regressions were performed to identify predictors of one-month mortality.