Factors predicting poor outcomes in elderly nursing home residents hospitalized due to COVID-19 pneumonia

INTRODUCTIONThe mortality of elderly patients residing in healthcare facilities from COVID-19 is high, as a result of which special measures to prevent the disease have been proposed by various centers for infection prevention and control.The purpose of this study is to examine the mortality of elderly patients residing in health facilities who were hospitalized with COVID-19 pneumonia in a long period of the pandemic.METHODS During the period 15 February 2021 to 31 December 2022, a total of 1398 elderly patients were hospitalized with COVID-19 pneumonia, of which 90 (6.4%) were nursing home residents and constituted the sample size for this study.The characteristics and outcomes of the patients in the hospital and within 90 days after diagnosis were recorded.RESULTS The mean age of institutionalized patients was 87.62 8.91 years, and 48 (53.3%) patients were females.Of the 90 patients, 46 (51.1%) died during their hospitalization, while a total of 56 (62.2%) died within the first 90 days.In univariable analysis, age, Charlson's comorbidity index (CCI), ferritin and albumin value were associated with in-hospital mortality; however, in multivariable regression analysis, none of the factors showed an independent correlation.From univariable Cox analysis, age, CCI and albumin were associated with 90-day mortality, while multivariable analysis showed that albumin was independently associated with 90-day mortality (HR=0.949;95% CI: 0.903-0.998).Albumin showed excellent predictive ability by ROC analysis for death within the first 90 days (AUC=0.978,p=0.001) with an albumin value 36.25 g/L being able to predict death within the first 90 days with 100% sensitivity and 83.3% specificity.CONCLUSIONS The mortality rate of elderly patients with COVID-19 pneumonia hospitalized in health facilities is high.Low albumin values are a predictor of adverse outcomes.