BACKGROUND
After the first wave of the new SARS-CoV-2 coronavirus infection, the researchers focused on identifying potential short- and long-term complications of COVID-19, especially in high-risk patients, after prolonged hospitalization and intensive care.
OBJECTIVE
To study the outcomes, adverse effects of severe COVID-19 and their predictors 90 days after hospital discharge in elderly patients with asthma.
MATERIAL AND METHODS
The study included elderly patients (101 subjects, 42 males and 59 females; median age 74 (67; 79) years) with asthma, discharged from the hospital after treatment of severe COVID-19. They were followed up for 90 days after discharge. In the hospital, COVID-19 was confirmed by laboratory tests (polymerase chain reaction method) and/or clinically and radiologically. All patients had a documented history of asthma according to GINA 2020 criteria.
RESULTS AND DISCUSSION
During the 90-day post-hospital follow-up, 86 (85%) patients survived, and 15 (15%) died after discharge. Deaths were reported within 1 to 4 weeks after discharge: 6 subjects died during re-hospitalization, 6 at home, and 3 in a rehabilitation center. The multivariate regression analysis model, adjusted for all statistically significant indicators, and the ROC analysis showed the most significant predictors of 90-day post-hospital mortality and their threshold values. They include the Charlson comorbidity index ≥4 points, lung damage according to computed tomography ≥30%, the absolute number of eosinophils ≤100 cells/μL, and concomitant diabetes mellitus. The analysis showed that 90-day post-hospital mortality depends on combinations of identified risk factors; a combination of two, three, and especially four risk factors statistically significantly is associated with patients’ lower average survival time.
CONCLUSION
The key risk factors for 90-day post-hospital mortality in elderly patients with asthma after severe COVID-19 include the Charlson comorbidity index, lung damage ≥30% according to computed tomography, the absolute number of eosinophils ≤100 cells/μL, and concomitant diabetes mellitus. The 90-day post-hospital survival rate is correlated with the number of risk factors identified in patients. The effect of asthma severity on 90-day post-hospital mortality in elderly patients was not observed.
