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Vera-Delgado V, García-Rosado D, Pérez-Hernández O, Martín-Ponce E, de La Paz-Estrello AM, García-Marichal C, Pérez-Fernández S, Rodríguez-Morón V, Alemán-Valls R, González-Reimers E, Martín-González C. Mortality and COVID Infection: Predictors of Mortality 10 Months after Discharge. Diseases 2024; 12:123. [PMID: 38920555 PMCID: PMC11203287 DOI: 10.3390/diseases12060123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The long-term survival of patients hospitalized with COVID-19 and the factors associated with poorer survival months after infection are not well understood. The aims of the present study were to analyze the overall mortality 10 months after admission. METHODS 762 patients with COVID-19 disease were included. Patients underwent a complete clinical evaluation, routine laboratory analysis and chest X-ray. Data collected included demographic and clinical data, such as vascular risk factors, tobacco or alcohol use, comorbidity, and institutionalization. RESULTS Ten-month mortality was 25.6%: 108 deaths occurred in-hospital, while 87 patients died after discharge. In-hospital mortality was independently related to NT-proBNP values > 503.5 pg/mL [OR = 4.67 (2.38-9.20)], urea > 37 mg/dL [3.21 (1.86-7.31)] and age older than 71 years [OR = 1.93 (1.05-3.54)]. NT-proBNP values > 503.5 pg/mL [OR = 5.00 (3.06-8.19)], urea > 37 mg/dL [3.51 (1.97-6.27)], cognitive impairment [OR = 1.96 (1.30-2.95), cancer [OR = 2.23 (1.36-3.68), and leukocytes > 6330/mm3 [OR = 1.64 (1.08-2.50)], were independently associated with long-term mortality. CONCLUSIONS the risk of death remains high even months after COVID-19 infection. Overall mortality of COVID-19 patients during 10 months after hospital discharge is nearly as high as that observed during hospital admission. Comorbidities such as cancer or cognitive impairment, organ dysfunction and inflammatory reaction are independent prognostic markers of long-term mortality.
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Affiliation(s)
- Víctor Vera-Delgado
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Dácil García-Rosado
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Onán Pérez-Hernández
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Esther Martín-Ponce
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Alejandro Mario de La Paz-Estrello
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | | | - Sergio Pérez-Fernández
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Valle Rodríguez-Morón
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Remedios Alemán-Valls
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
| | - Emilio González-Reimers
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
| | - Candelaria Martín-González
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
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Smadi M, Kaburis M, Schnapper Y, Reina G, Molero P, Molendijk ML. SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses. Br J Psychiatry 2023:1-14. [PMID: 37183681 DOI: 10.1192/bjp.2023.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND People with neurodegenerative disease and mild cognitive impairment (MCI) may have an elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may be disproportionally affected by coronavirus disease 2019 (COVID-19) once infected. AIMS To review all eligible studies and quantify the strength of associations between various pre-existing neurodegenerative disorders and both SARS-CoV-2 susceptibility and COVID-19 illness course and outcome. METHOD Pre-registered systematic review with frequentist and Bayesian meta-analyses. Systematic searches were executed in PubMed, Web of Science and preprint servers. The final search date was 9 January 2023. Odds ratios (ORs) were used as measures of effect. RESULTS In total, 136 primary studies (total sample size n = 97 643 494), reporting on 268 effect-size estimates, met the inclusion criteria. The odds for a positive SARS-CoV-2 test result were increased for people with pre-existing dementia (OR = 1.83, 95% CI 1.16-2.87), Alzheimer's disease (OR = 2.86, 95% CI 1.44-5.66) and Parkinson's disease (OR = 1.65, 95% CI 1.34-2.04). People with pre-existing dementia were more likely to experience a relatively severe COVID-19 course, once infected (OR = 1.43, 95% CI 1.00-2.03). People with pre-existing dementia or Alzheimer's disease were at increased risk for COVID-19-related hospital admission (pooled OR range: 1.60-3.72). Intensive care unit admission rates were relatively low for people with dementia (OR = 0.54, 95% CI 0.40-0.74). All neurodegenerative disorders, including MCI, were at higher risk for COVID-19-related mortality (pooled OR range: 1.56-2.27). CONCLUSIONS Our findings confirm that, in general, people with neurodegenerative disease and MCI are at a disproportionally high risk of contracting COVID-19 and have a poor outcome once infected.
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Affiliation(s)
- Muhannad Smadi
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Melina Kaburis
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Youval Schnapper
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Gabriel Reina
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Microbiology, Pamplona, Spain
| | - Patricio Molero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Psychiatry and Medical Psychology, Pamplona, Spain
| | - Marc L Molendijk
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands; and Leiden Institute for Brain and Cognition, Leiden University Medical Centre, Leiden, The Netherlands
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Sawik B, Tobis S, Baum E, Suwalska A, Kropińska S, Stachnik K, Pérez-Bernabeu E, Cildoz M, Agustin A, Wieczorowska-Tobis K. Robots for Elderly Care: Review, Multi-Criteria Optimization Model and Qualitative Case Study. Healthcare (Basel) 2023; 11:healthcare11091286. [PMID: 37174828 PMCID: PMC10178192 DOI: 10.3390/healthcare11091286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
This paper focuses on three areas: the first is a review of current knowledge about social and service robots for elderly care. The second is an optimization conceptual model aimed at maximizing the efficiency of assigning robots to serve the elderly. The proposed multi-criteria optimization model is the first one proposed in the area of optimization for robot assignment for the elderly with robot utilization level and caregiver stress level. The third is the findings of studies on the needs, requirements, and adoption of technology in elderly care. We consider the use of robots as a part of the ENRICHME project for long-term interaction and monitoring of older persons with mild cognitive impairment, to optimize their independence. Additionally, we performed focus group discussions (FGD) to collect opinions about robot-related requirements of the elderly and their caregivers. Four FDGs of six persons were organized: two comprising older adults, and two of the other formal and informal caregivers, based on a detailed script. The statements of older participants and their caregivers were consistent in several areas. The analysis revealed user characteristics, robot-related issues, functionality, and barriers to overcome before the deployment of the robot. An introduction of the robot must be thoroughly planned, include comprehensive pre-training, and take the ethical and practical issues into account. The involvement of future users in the customization of the robot is essential.
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Affiliation(s)
- Bartosz Sawik
- Department of Business Informatics and Engineering Management, AGH University of Science and Technology, 30-059 Krakow, Poland
- Institute of Smart Cities, Department of Statistics, Computer Science and Mathematics, Public University of Navarre, 31006 Pamplona, Spain
- Haas School of Business, University of California at Berkeley, Berkeley, CA 94720, USA
| | - Sławomir Tobis
- Occupational Therapy Unit, Chair of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, ul. Swiecickiego 6, 60-781 Poznan, Poland
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Aleksandra Suwalska
- Department of Mental Health, Chair of Psychiatry, Poznan University of Medical Sciences, ul. Szpitalna 27/33, 60-572 Poznan, Poland
| | - Sylwia Kropińska
- Geriatrics Unit, Chair of Palliative Medicine, Poznan University of Medical Sciences, os. Rusa 55, 61-245 Poznan, Poland
| | - Katarzyna Stachnik
- Geriatrics Unit, Chair of Palliative Medicine, Poznan University of Medical Sciences, os. Rusa 55, 61-245 Poznan, Poland
| | - Elena Pérez-Bernabeu
- Department of Applied Statistics and Operations Research, Universitat Politècnica de València, Plaza Ferrandiz y Carbonell, sn, 03801 Alcoy, Spain
| | - Marta Cildoz
- Institute of Smart Cities, Department of Statistics, Computer Science and Mathematics, Public University of Navarre, 31006 Pamplona, Spain
| | - Alba Agustin
- Institute of Smart Cities, Department of Statistics, Computer Science and Mathematics, Public University of Navarre, 31006 Pamplona, Spain
| | - Katarzyna Wieczorowska-Tobis
- Geriatrics Unit, Chair of Palliative Medicine, Poznan University of Medical Sciences, os. Rusa 55, 61-245 Poznan, Poland
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Frigotto MF, Rodrigues R, Rabello R, Pietta-Dias C. COVID-19 in older adult residents in nursing homes: factors associated with mortality and impact on functional capacity. SPORT SCIENCES FOR HEALTH 2023; 19:527-535. [PMID: 36855399 PMCID: PMC9951134 DOI: 10.1007/s11332-022-01040-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/30/2022] [Indexed: 03/02/2023]
Abstract
Objective To verify if the functional capacity prior to COVID-19 infection was different between Survivor and Non-survivor older adults. Also, to verify the effect of the isolation period after COVID-19 infection on the functional capacity of the Survivors residing in nursing homes. Materials and methods Older adults residing in nursing homes were evaluated 30 days before the COVID-19 outbreak at the site for (i) general health characteristics (obtained from medical records); (ii) gait speed, handgrip strength and 30-s sit-to-stand; (iii) sarcopenia and (iv) estimated muscle mass. Comparisons were made between Survivors and Non-survivors of COVID-19. After the isolation, the Survivors performed the assessments again. Results Twenty-one (81 ± 9.3 years) participants tested positive for COVID-19 and participated in the study, 12 survivors. No difference was observed between Survivors and Non-survivors in any of the outcomes evaluated. However, a moderate effect size was observed for handgrip strength, with lower values for the Non-survivors group (- 16%; d = 0.53). The isolation period reduced the number of sit-to-stand repetitions with moderate effect size in the Survivors (p = 0.046, gav = 0.66). Conclusion Although the null hypothesis analysis did not find significant differences between the groups, the effect size suggests that older adults residing in nursing homes who died from COVID-19 had lower handgrip strength. In the survivors, the isolation period after COVID-19 infection only negatively impacted the sit-to-stand performance.
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Affiliation(s)
- Michele Fernandes Frigotto
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS 90690-200 Brazil
| | - Rodrigo Rodrigues
- Institute of Education, Federal University of Rio Grande, Rio Grande, RS Brazil
| | - Rodrigo Rabello
- Department of Biomedical Sciences for Health, University of Milan, Milan, MI Italy
| | - Caroline Pietta-Dias
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS 90690-200 Brazil
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Wang Y, Nan L, Hu M, Zhang R, Hao Y, Wang Y, Yang H. Significant association between anemia and higher risk for COVID-19 mortality: A meta-analysis of adjusted effect estimates. Am J Emerg Med 2022; 58:281-285. [PMID: 35753290 PMCID: PMC9217068 DOI: 10.1016/j.ajem.2022.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to evaluate whether there was a significant relationship between anemia and the risk for mortality among coronavirus disease 2019 (COVID-19) patients by a quantitative meta-analysis based on the adjusted effect estimates. Methods A systematic search was conducted in electronic databases to identify all published literature. A random-effects meta-analysis model was used to estimate the pooled effect size and 95% confidence interval (CI). Heterogeneity test, Begg's test, subgroup analysis and meta-regression were performed. Results Twenty-three articles with 573,928 COVID-19 patients were included in the quantitative meta-analysis. There was a significant association between anemia and an elevated risk of COVID-19 mortality (pooled effect size = 1.47, 95% CI [1.30–1.67]). We observed this significant association in the further subgroup analyses by age, proportion of males, sample size, study design, region and setting. Sensitivity analysis exhibited that our results were reliable. Begg's test showed that there was no publication bias. Meta-regression indicated that the tested variables might not be the source of heterogeneity. Conclusion Our meta-analysis based on risk factors-adjusted effect estimates indicated that anemia was independently associated with a significantly elevated risk for mortality among COVID-19 patients.
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Affiliation(s)
- Ying Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Lan Nan
- Yusuf Hamied Department of Chemistry, University of Cambridge, UK
| | - Mengke Hu
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Ruiying Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Yuqing Hao
- International College of Zhengzhou University, Zhengzhou 450052, China
| | - Yadong Wang
- Department of Toxicology, Henan, Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - Haiyan Yang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China.
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