The Effects of Polypharmacy, Nutritional, Functional Status on the Progression of COVID-19 in Older Adults

Objective: We aimed to evaluate the effects of nutritional factors, dependence in daily life activities, and polypharmacy on the length of hospitalization, clinical prognosis and mortality among hospitalized older COVID-19 patients.Materials and Methods: The charts of hospitalized COVID-19 patients older than 60 years old were reviewed retrospectively. We obtained findings on admission, comorbidities and the number of drugs used. The Mini Nutritional Assessment (MNA), the Barthel Index for Activities of Daily Living (BADL) and the Lawton Instrumental Activities of Daily Living (IADL) Scale were used to analyze the findings.Results: Out of the 73 patients, 39 were female and the mean age was 69.65 +/- 7.39 years. Fourteen (19.2%) patients were transferred to the intensive care unit, and nine (12.3%) of them died. After adjustment for age, the number of respiration at the first admission was significantly higher (p=0.001), and BADL, IADL scores and oxygen saturations were significantly lower (p=0.00, p=0.001) in the patients transferred to the intensive care unit compared to the patients discharged. There was no association between the length of hospitalization and age, the number of drugs, BADL and IADL scores, but there was a significant negative correlation between the length of hospitalization (r:-0.310), MNA score (r:-0.275) and daily protein intake (p=0.008). No association between polypharmacy and clinical progression of COVID-19 was detected (p=0.109).Conclusion: Decrease in MNA scores and daily protein intake in older COVID-19 patients were associated with prolonged hospitalization. Functional dependence was associated with the need for intensive care and mortality.