Article Figures & Tables
Tables
- Table 1:
Baseline characteristics of adults aged ≥ 65 years admitted to acute care hospital with COVID-19
Characteristic No. (%) of patients*
n = 927No. (%) of records missing
n = 927Age, yr, median (IQR) 79.0 (72.0–87.0) 0 Female 417 (45.0) 0 From long-term care 174 (18.8) 2 (0.2) Any impairment in activities of daily living 359 (38.7) 0 Any impairment in instrumental activities of daily living 497 (53.6) 0 Clinical Frailty Scale 35 (3.8) Mean score ± SD 4.95 ± 1.55 – Frail (score ≥ 5) 552 (61.9) – Baseline mobility 22 (2.4)† Walks independently 371 (41.0) – Walks with cane 56 (6.2) – Walks with walker 245 (27.1) – Wheelchair 90 (9.9) – Bed-bound 44 (4.9) – Undocumented 99 (10.9) – Comorbidities Dementia 212 (23.1) 10 (1.1) Falls 132 (14.3) 5 (0.5) Heart failure 131 (14.2) 6 (0.6) Coronary artery disease 220 (23.9) 6 (0.6) Chronic kidney disease 189 (20.5) 5 (0.5) Stroke 170 (18.5) 6 (0.6) Hypertension 637 (69.0) 4 (0.4) Diabetes 369 (40.0) 5 (0.5) Chronic obstructive pulmonary disease 112 (12.2) 7 (0.8) Cancer 217 (23.6) 7 (0.8) Baseline code status 95 (10.2)† Full code 463 (55.6) – Do not resuscitate 329 (39.5) – Only intubation 21 (2.5) – Other option 8 (1.0) – Undocumented 11 (1.3) – Presenting characteristics Any infiltrate on chest x-ray 632 (68.2) 39 (4.2) Maximum temperature on presentation, °C, median (IQR) 37.7 (37.0–38.4) 120 (13.0) Days from prodromal symptoms to COVID-19 diagnosis, median (IQR) 3.0 (1.0–7.0) 115 (12.4) - Table 2:
Characteristics, outcomes and treatments of adults aged ≥ 65 years admitted to rehabilitation or long-term care hospitals with COVID-19*
Characteristic No. (%) of patients†
n = 115Age, yr, median (IQR) 86.0 (78.5–91.0) Female 72 (62.6) Rehabilitation hospital 44 (38.3) Long-term care 71 (61.7) Clinical Frailty Scale Mean score ± SD 6.80 ± 1.17 Frail (score ≥ 5) 109 (94.8) Comorbidities Dementia 56 (48.7) Falls 53 (46.1) Heart failure 17 (14.8) Coronary artery disease 27 (23.5) Chronic kidney disease 13 (11.3) Stroke 21 (18.3) Hypertension 68 (59.1) Diabetes 38 (33.0) Chronic obstructive pulmonary disease 9 (7.8) Cancer 25 (21.7) Presenting characteristics Any infiltrate on chest x-ray 7 (6.1) Maximum temperature on presentation, °C, median (IQR) 37.5 (36.9–38.0) Outcomes In-hospital death 28 (24.3) Delirium 17 (14.8) Any complications 44 (38.3) Complications Fall 19 (16.5) Pneumonia 16 (13.9) Aspiration 2 (1.7) Respiratory failure 8 (7.0) Acute respiratory distress syndrome 4 (3.5) Use of restraints 0 (0) Treatments Dexamethasone 25 (21.7) Azithromycin 7 (6.1) Other antibiotics 16 (13.9) - Table 3:
Treatments and outcomes of adults aged ≥ 65 years admitted to acute care hospital with COVID-19
Characteristic No. (%) of patients*
n = 927No. (%) of records missing
n = 927COVID-19 treatment Dexamethasone 460 (49.6) 0 Azithromycin 203 (21.9) 0 Remdesivir 99 (10.7) 0 Other steroid 56 (6.0) 0 Tocilizumab 25 (2.7) 0 Convalescent plasma 18 (1.9) 0 Lopinavir or ritonavir 6 (0.6) 0 Hydroxychloroquine 4 (0.4) 0 Participation in clinical trial 80 (8.6) 12 (1.3) Surgery in hospital 44 (4.7) 4 (0.4) Outcomes In-hospital death 262 (28.4) 3 (0.3) Length of stay, median (IQR) 11.0 (6.0–22.0) 13 (1.4) Delirium prevalence 497 (53.6) 0 Delirium incidence† 201/608 (33.1) 0 ICU admission 215 (23.4) 8 (0.9) Any complications 432 (46.6) 0 Palliative care in hospital 199 (21.5) 9 (1.0) Complications Use of restraints 189 (20.4) 0 Respiratory failure 154 (16.6) 0 Acute respiratory distress syndrome 101 (10.9) 0 Other infection 68 (7.3) 0 Aspiration 59 (6.4) 0 Hospital-acquired pneumonia 45 (4.9) 0 In-hospital fall 45 (4.9) 0 Stroke 22 (2.4) 0 Pulmonary embolism 20 (2.2) 0 Heart failure 19 (2.0) 0 Myocardial infarction 18 (1.9) 0 Deep vein thrombosis 9 (1.0) 0 - Table 4:
Delirium characteristics of adults aged ≥ 65 years admitted to acute care hospital with COVID-19
Characteristic No. (%) of patients*
n = 497No. (%) of records missing
n = 497Age, yr, median (IQR) 82.0 (74.0–89.0) 0 Female 220 (44.3) 0 History of behavioural and psychological symptoms of dementia 110 (22.1) 14 (2.8) Motor subtype 13 (2.6) Hyperactive 142 (28.6) – Hypoactive 182 (36.6) – Mixed 83 (16.7) – No subtype 84 (16.9) – Evidence of agitation 283 (56.9) 9 (1.8) Use of restraints 184 (37.0) 7 (1.4) Use of any sedating medication 335 (67.4) 22 (4.4) Use of antipsychotics 266 (53.5) 13 (2.6) Use of benzodiazepines 154 (31.0) 11 (2.2) Presence of family or caregivers in person 101 (20.3) 16 (3.2) Use of virtual technology for family or caregivers who could not be present in person 278 (55.9) 21 (4.2) Note: IQR = interquartile range.
↵* Unless otherwise indicated.
- Table 5:
Characteristics and outcomes associated with the use of dexamethasone, remdesivir and tocilizumab in acute care patients during wave 2* of the COVID-19 pandemic
Characteristic Dexamethasone
n = 631Remdesivir
n = 631Tocilizumab
n = 631No Yes RR or MD (95% CI)† No Yes RR or MD (95% CI)† No Yes RR or MD (95% CI)† No. (%) of patients 180 (28.5) 451 (71.5) – 532 (84.3) 99 (15.7) – 607 (96.2) 24 (3.8) – Characteristics Age, median (IQR) 79.0 (71.0–86.0) 80.0 (72.0–88.0) – 81.0 (72.0–88.0) 75.0 (69.5–84.5) – 80.0 (72.0–88.0) 73.5 (70.0–81.0) – Female, no. (%) 98 (54.4) 193 (42.8) – 253 (47.6) 38 (38.4) – 281 (46.3) 10 (41.7) – Frailty, no. (%)‡ 104 (57.8) 274 (60.8) – 339 (63.7) 39 (39.4) – 371 (61.1) 7 (29.2) – Dementia, no. (%) 42 (23.3) 106 (23.5) – 137 (25.8) 11 (11.1) – 147 (24.2) 1 (4.2) – Chest x-ray infiltrates, no. (%) 87 (48.3) 354 (78.5) – 361 (67.9) 80 (80.8) – 425 (70.0) 16 (66.7) – Fever, no. (%) 60 (33.3) 239 (53.0) – 242 (45.5) 57 (57.6) – 281 (46.3) 18 (75.0) – C-reactive protein, mg/dL, median (IQR) 30.5 (11.0–53.2) 88.6 (49.4–157.5) – 71.6 (31.1–134.1) 65.0 (48.0–134.0) – 62.0 (33.0–127.0) 148.7 (88.2–183.9) – Outcomes In-hospital death, no. (%) 13 (7.2) 168 (37.3) 1.46 (1.35–1.59) 155 (29.1) 26 (26.3) 0.88 (0.58–1.33) 172 (28.3) 9 (37.5) 1.48 (0.66–3.32) Length of stay, d, median (IQR) 7.0 (3.0–14.0) 11.0 (7.0–21.0) 4.0 (2.0–5.0) 10.0 (5.0–19.0) 11.0 (7.0–22.0) 1.0 (0–3.0) 10.0 (6.0–19.0) 14.0 (7.8–20.0) 2.0 (−2.0 to 6.0) Delirium prevalence, no. (%) 66 (36.7) 266 (59.0) 1.29 (1.16–1.43) 287 (53.9) 45 (45.5) 0.75 (0.52–1.08) 316 (52.1) 16 (66.7) 1.80 (0.78–4.13) Delirium incidence, no. (%)§ 29/136 (21.3) 103/277 (37.2) 1.26 (1.11–1.43) 109/338 (32.2) 23/75 (30.7) 0.94 (0.60–1.47) 125/399 (31.3) 7/14 (50.0) 2.13 (0.76–5.95) ICU admission, no. (%) 20 (11.1) 128 (28.4) 1.30 (1.19–1.42) 128 (24.1) 20 (20.2) 0.82 (0.52–1.29) 134 (22.1) 14 (58.3) 4.54 (2.06–10.01) Complications Use of restraints, no. (%) 17 (9.4) 109 (24.2) 1.27 (1.16–1.40) 105 (19.7) 21 (21.2) 1.08 (0.69–1.67) 120 (19.8) 6 (25.0) 1.33 (0.54–3.29) Falls, no. (%) 12 (6.7) 22 (4.9) 0.90 (0.70–1.16) 31 (5.8) 3 (3.0) 0.55 (0.18–1.64) 33 (5.4) 1 (4.2) 0.76 (0.11–5.48) Respiratory failure, no. (%) 7 (3.9) 104 (23.1) 1.40 (1.30–1.51) 93 (17.5) 18 (18.2) 1.04 (0.65–1.66) 104 (17.1) 7 (29.2) 1.93 (0.82–4.53) Acute respiratory distress syndrome, no. (%) 2 (1.1) 74 (16.4) 1.43 (1.34–1.53) 63 (11.8) 13 (13.1) 1.10 (0.65–1.88) 70 (11.5) 6 (25.0) 2.43 (1.00–5.93) Note: CI = confidence interval, ICU = intensive care unit, IQR = interquartile range, MD = mean difference, RR = relative risk.
↵* Aug. 1, 2020, to Feb. 20, 2021.
↵† Where appropriate.
↵‡ Defined as a score on the Clinical Frailty Scale ≥ 5.
↵§ Calculated by excluding those who presented with delirium, so the base population size was different for this row.
- Table 6:
Multivariable model of dexamethasone as the main predictor of delirium incidence in adults aged ≥ 65 years admitted to acute care hospitals with COVID-19 in wave 2 of the COVID-19 pandemic*
Variable Unadjusted OR Adjusted OR† Dexamethasone use 2.11 (1.32–3.46) 1.38 (0.77–2.50) Remdesivir use 0.93 (0.53–1.58) 1.56 (0.80–3.04) Tocilizumab use 2.19 (0.74–6.53) 2.53 (0.73–9.24) Age, yr‡ 1.31 (1.17–1.48) 1.21 (1.04–1.40) Dementia 4.99 (2.86–8.89) 3.25 (1.67–6.45) Clinical Frailty Scale score 1.53 (1.32–1.79) 1.53 (1.24–1.91) Intensive care unit admission 2.94 (1.82–4.77) 6.82 (3.65–13.11)