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Morandi A, Gual N, Cesari M, Mota M, Buttò V, Gentile S, Balestreri G, Camussi A, Platto C, Roig T, de Andrés AM, Bellelli G, Inzitari M. Geriatric syndromes and functions in older adults with COVID-19 hospitalized in sub-acute care: a multicenter study. Aging Clin Exp Res 2023; 35:221-226. [PMID: 36280623 PMCID: PMC9591316 DOI: 10.1007/s40520-022-02264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/20/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Alternatives to conventional acute hospitalizations have been particularly useful during the COVID-19 pandemic. However, little is known on the management and outcomes of COVID-19 in older patient admitted to non-acute settings. The main aim of this study was to determine the effect of geriatrics syndromes on functional outcomes in older COVID-19 patients cared in sub-acute units. METHODS Prospective multicenter observational cohort study of patients aged 65 years and older with COVID-19, admitted to sub-acute units in Italy and Spain. Multivariable logistic regression models were used to test the association between geriatric syndromes and other clinical variables, and the functional status at discharge, defined by a Barthel Index > = 80. RESULTS A total of 158 patients were included in the study with a median age of 82 [Interquartile Range 81, 83]; of these 102 (65%) patients had a Barthel Index ≥ 80 at discharge. In the main multivariable logistic regression model a higher severity of frailty-measured with the Clinical Frailty Scale-(OR 0.30; CI 0.18-0.47), and the presence of delirium (OR 0.04; CI 0.00-0.35) at admission were associated with lower odds of a higher functional status at discharge. Other variables associated with lower functional status were female gender (OR 0.36; CI 0.13-0.96), and a higher number of comorbidities (OR 0.48; CI 0.26-0.82). CONCLUSION The study reports a relatively high prevalence of functional recovery for older COVID-19 patients admitted to sub-acute units. Additionally, it underlines the importance of targeting geriatrics syndromes, in particular frailty and delirium, for their possible effects on functional recovery.
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Affiliation(s)
- Alessandro Morandi
- Azienda Speciale Cremona Solidale, Via Zocco 21, 26100, Cremona, Italy.
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain.
| | - Neus Gual
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Matteo Cesari
- IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Miriam Mota
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Valeria Buttò
- Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy
| | - Simona Gentile
- Azienda Speciale Cremona Solidale, Via Zocco 21, 26100, Cremona, Italy
| | - Genny Balestreri
- Geriatric Clinic Unit, University-Hospital of Parma, Parma, Italy
| | - Alessandro Camussi
- Ginecologia, Dipartimento Materno Infantile, ISSR Sa Raffaele, Milan, Italy
| | - Caterina Platto
- Department of Internal Medicine, ASST Cremona, Cremona, Italy
| | - Thais Roig
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Ana M de Andrés
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
| | - Giuseppe Bellelli
- Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Inzitari
- REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebrón Institut de Recerca (VHIR), Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
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