ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month mortality in older inpatients with Covid-19
Bousquet et al.,
ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month..,
Aging, 12:12, 11306-11313, doi:10.18632/aging.103583
Observational prospective 108 hospitalized patients 65 and older, showing HCQ mortality OR 0.49, p = 0.15.
risk of death, 42.8% lower, RR 0.57, p = 0.15, treatment 5 of 27 (18.5%), control 23 of 81 (28.4%), NNT 10, adjusted per study, odds ratio converted to relative risk.
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Bousquet et al., 23 Jun 2020, prospective, France, peer-reviewed, 10 authors.
Abstract: www.aging-us.com
AGING 2020, Vol. 12, No. 12
Research Paper
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,*,#
1
AP-HP Hôpital Avicenne, Oncologie Médicale, Bobigny 93000, France
Université Sorbonne Paris Nord, INSERM, U942, Cardiovascular Markers in Stressed Conditions, MASCOT,
Bobigny 93000, France
3
AP-HP Hôpital Avicenne, Unité de Médecine Ambulatoire (UMA), Bobigny 93000, France
4
Université Sorbonne Paris Nord, Villetaneuse 93430, France
5
AP-HP Hôpital Avicenne, Gastroentérologie et Oncologie Digestive Bobigny 93000, France
6
AP-HP Hôpital Avicenne, Rhumatologie, Bobigny 93000, France
7
AP-HP Hôpital Avicenne, Médecine Interne, ESH Hypertension Excellence Centre, Bobigny 93000, France
8
AP-HP Hôpital Avicenne, Cardiologie, Bobigny 93000, France
9
APHP Hôpital Avicenne, Service de Médecine Gériatrique, Bobigny 93000, France
10
AP-HP Hôpital Avicenne, Pneumologie, Bobigny 93000, France
11
Université Sorbonne Paris Nord, INSERM, U1272, « Hypoxia and Lung », Bobigny 93000, France
12
AP-HP Hôpital Avicenne, Infectious Diseases, Bobigny 93000, France
13
EA 3412, Laboratoire Educations et Pratiques de Santé, Bobigny 93000, France
*Equal contribution
#
Co-senior author
2
Correspondence to: Frédéric Pamoukdjian; email: frederic.pamoukdjian@aphp.fr
Keywords: COVID-19, geriatric assessment, mortality, predictive biomarkers, anticoagulation
Received: May 12, 2020
Accepted: June 12, 2020
Published: June 23, 2020
Copyright: 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, CReactive 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..
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