Clinical characteristics of older patients with COVID-19: a systematic review of case reports

Córdova, Luisser Dainner Saavedra; Vega, Alexander Pieter Mayor; Luján-Carpio, Elmer; Parodi, José Francisco; Moncada-Mapelli, Enrique; Armacanqui-Valencia, Isai; Salvador-Ruiz, Jhonatanael; Pawer-Pucurimay, Dalia; Ydrogo-Cruz, Erickson; Chevarría-Arriaga, Mylenka Jennifer; Ganoza-Farro, Macarena; Meza-Romero, Araceli; Zegarra-Rodríguez, Cynthia Alejandra; Albán-Murguia, Pedro Gustavo; Bailón-Valdez, Zaira; Palacios-Garcia, Naheilli; Quevedo-La-Torre, Danae; Alcós-Mamani, Angelica Lizeth; Gómez-Martel, Luisa Alisson; Roca-Moscoso, Max Antonio; Gamboa-Orozco, Martin; Salazar-Granara, Alberto

doi:10.1590/1980-57642021dn15-010001

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Dementia & Neuropsychologia

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Original Article • Dement Neuropsychol 15 (1) • Jan-Mar 2021 • https://doi.org/10.1590/1980-57642021dn15-010001 copy

Clinical characteristics of older patients with COVID-19: a systematic review of case reports

CARACTERÍSTICAS CLÍNICAS DE PACIENTES IDOSOS COM COVID-19: UMA REVISÃO SISTEMÁTICA DE RELATOS DE CASOS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

In the context of the current COVID-19 pandemic, higher morbidity and mortality have been reported in older adults. This age group presents physiological changes and its own clinical conditions such as frailty, dementia, among others.

Objective:

To describe the characteristics of COVID-19 patients, both over and under 80 years old, by conducting a systematic review of the literature describing case reports, and to summarize and critically assess these characteristics.

Methods:

Systematic review. The study was registered on the Registry of Health Research Projects (PRISA) of the Peruvian National Institute of Health (code EI00000631). Five electronic databases (Scopus, PubMed, PubMed Central, LILACS, and SCIELO) were systematically searched during the period between December 31, 2019 and April 16, 2020. The search focused on case reports, case studies, and case series of older people with COVID-19 infection aged over or under 80 years. When selecting the cases, priority was given to clinical and epidemiological profile, laboratory and imaging patterns, and comprehensive geriatric evaluation.

Results:

1,149 articles were identified; after applying the filters, a total of 15 publications of case reports and complete records of 27 older adults were obtained. The most frequent age group was between 60 to 69 years old. There is little literature regarding case reports of older adults aged over 80 years. The most frequent parameters were hypertension, fever, cough, respiratory distress, ground-glass opacification in chest radiography and tomography. Furthermore, decrease in PaO₂/FiO₂ ratio and lymphocytes, and increase in C-reactive protein and Interleukin 6 were observed.

Conclusions:

This systematic review found little available information of patients under 80 years old, and far less for those over 80 years old, and an absence of comprehensive geriatric assessment.

Keywords:
coronavirus infections; SARS-CoV-2; aged; case reports; systematic review

Systematic review items
Keywords^* * Excerpted from Medical Subject Headings of the National Library of Medicine of the United States of America, and Health Sciences Descriptors from BIREME – Latin American and Caribbean Center for Information in Health Sciences. OR and AND are Booleans. SCOPUS: Elsevier's abstract and citation database. PUBMED CENTRAL (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health, National Library of Medicine (NIH/NLM). PUBMED (MEDLINE) is a database of references and abstracts on life sciences and biomedical topics of the U.S. National Library of Medicine (NLM). SCIELO: Scientific Electronic Library Online is a bibliographic database supported by the São Paulo Research Foundation (FAPESP) and the Brazilian National Council for Scientific and Technological Development (CNPq). Latin American and the Caribbean Health Sciences Literature (LILACS) is an online bibliographic database in medicine and health sciences, maintained by the Latin American and Caribbean Center on Health Sciences Information.
COVID-19, SARS-CoV-2, Wuhan coronavirus, 2019-nCoV, novel coronavirus, new coronavirus, 2019-novel coronavirus, COVID-19 pandemic, COVID-19 virus infection, coronavirus-19 disease, 2019-nCoV infection, 2019-nCoV disease, COVID-19 virus disease, Aged 80 and over, Oldest-Old, Nonagenarian, Octogenarian, Centenarian, Nonagenarians, Octogenarians, Centenarians, Frail Elderly, Aged, Elderly. Anciano de 80 o más Años, Ancianos de 80 Años y más Anciano, Anciano Frágil, Centenarios, Nonagenarios, Octogenarios, Adulto Mayor, Ancianos, Persona Mayor, Persona de Edad, Personas Mayores, Salud de la Persona Anciana, Salud de la Persona Mayor, Salud de la Tercera Edad, Tercera edad, y Longevos.
SCOPUS search strategy
(TITLE-ABS-KEY (“COVID-19”) OR TITLE-ABS-KEY (“SARS-CoV-2”) OR TITLE-ABS-KEY (“Wuhan coronavirus”) OR TITLE-ABS-KEY (“2019-nCoV”) OR TITLE-ABS-KEY (“novel coronavirus”) OR TITLE-ABS-KEY (“new coronavirus”) OR TITLE-ABS-KEY (“2019-novel coronavirus”) OR TITLE-ABS-KEY (“COVID-19 pandemic”) OR TITLE-ABS-KEY (“COVID-19 virus infection”) OR TITLE-ABS-KEY (“coronavirus disease-19”) OR TITLE-ABS-KEY (“2019-nCoV infection”) OR TITLE-ABS-KEY (“2019-nCoV disease”) OR TITLE-ABS-KEY (“COVID-19 virus disease”)) AND (TITLE-ABS-KEY (“Aged, 80 and over”) OR TITLE-ABS-KEY (“Oldest Old”) OR TITLE-ABS-KEY (“Nonagenarian”) OR TITLE-ABS-KEY (“Octogenarian”) OR TITLE-ABS-KEY (“Centenarian”) OR TITLE-ABS-KEY (“Nonagenarians”) OR TITLE-ABS-KEY (“Octogenarians”) OR TITLE-ABS-KEY (“Centenarians”) OR TITLE-ABS-KEY (“Frail Elderly”) OR TITLE-ABS-KEY (“Aged”) OR TITLE-ABS-KEY (“Elderly”))
PubMed Central search strategy
((((((“Aged, 80 and over”[MeSH Terms] OR (“aged”[MeSH Terms] OR “Frail Elderly”[MeSH Terms])) OR (((((((((“Aged, 80 and over”[Abstract]) OR Aged[Abstract]) OR “Frail Elderly”[Abstract]) OR “Oldest Old”[Abstract]) OR Nonagenarians[Abstract]) OR Nonagenarian[Abstract]) OR Octogenarians[Abstract]) OR Octogenarian[Abstract]) OR Centenarians[Abstract]) OR Centenarian[Abstract]) OR Elderly[Abstract])) OR (((((((((“Aged, 80 and over”[Title]) OR Aged[Title]) OR “Frail Elderly”[Title]) OR “Oldest Old”[Title]) OR Nonagenarians[Title]) OR Nonagenarian[Title]) OR Octogenarians[Title]) OR Octogenarian[Title]) OR Centenarians[Title]) OR Centenarian[Title]) OR Elderly[Title]))))) AND (((COVID-19[Supplementary Concept]) OR (((((((((((((2019-nCoV[Abstract]) OR COVID-19[Abstract]) OR SARS-CoV-2[Abstract]) OR “new coronavirus”[Abstract]) OR “novel coronavirus”[Abstract]) OR “2019-novel coronavirus”[Abstract]) OR “COVID-19 pandemic”[Abstract]) OR “COVID-19 virus infection”[Abstract]) OR “coronavirus disease-19”[Abstract]) OR “2019-nCoV infection”[Abstract]) OR “2019-nCoV disease”[Abstract]) OR “Wuhan coronavirus”[Abstract]) OR “COVID-19 virus disease”[Abstract])) OR (((((((((((((2019-nCoV[Title]) OR COVID-19[Title]) OR SARS-CoV-2[Title]) OR “new coronavirus”[Title]) OR “novel coronavirus”[Title]) OR “2019-novel coronavirus”[Title]) OR “COVID-19 pandemic”[Title]) OR “COVID-19 virus disease”[Title]) OR “Wuhan coronavirus”[Title]) OR “2019-nCoV disease”[Title]) OR “2019-nCoV infection”[Title]) OR “coronavirus disease-19”[Title]) OR “COVID-19 virus infection”[Title]))
PubMed (Medline) search strategy
(((((((((((((((((2019-nCoV[Other Term]) OR COVID-19[Other Term]) OR SARS-CoV-2[Other Term]) OR “new coronavirus”[Other Term]) OR “novel coronavirus”[Other Term]) OR “2019-novel coronavirus”[Other Term]) OR “COVID-19 pandemic”[Other Term]) OR “COVID-19 virus disease”[Other Term]) OR “Wuhan coronavirus”[Other Term]) OR “2019-nCoV disease”[Other Term]) OR “2019-nCoV infection”[Other Term]) OR “coronavirus disease-19”[Other Term]) OR “COVID-19 virus infection”[Other Term])) OR COVID-19[Supplementary Concept]) OR (((((((((((((2019-nCoV[Title/Abstract]) OR COVID-19[Title/Abstract]) OR SARS-CoV-2[Title/Abstract]) OR “new coronavirus”[Title/Abstract]) OR “novel coronavirus”[Title/Abstract]) OR “2019-novel coronavirus”[Title/Abstract]) OR “COVID-19 pandemic”[Title/Abstract]) OR “Wuhan coronavirus”[Title/Abstract]) OR “COVID-19 virus disease”[Title/Abstract]) OR “2019-nCoV disease”[Title/Abstract]) OR “2019-nCoV infection”[Title/Abstract]) OR “coronavirus disease-19”[Title/Abstract]) OR “COVID-19 virus infection”[Title/Abstract]))) AND ((((((((((((((((“Aged, 80 and over”[Title/Abstract] OR Aged[Title/Abstract]) OR “Frail Elderly”[Title/Abstract]) OR “Oldest Old”[Title/Abstract]) OR Nonagenarians[Title/Abstract]) OR Nonagenarian[Title/Abstract]) OR Octogenarians[Title/Abstract]) OR Octogenarian[Title/Abstract]) OR Centenarians[Title/Abstract]) OR Centenarian[Title/Abstract]) OR Elderly[Title/Abstract]) OR ((“Aged, 80 and over”[MeSH Terms] OR “aged”[MeSH Terms]) OR “Frail Elderly”[MeSH Terms])) OR ((((((((((“Aged, 80 and over”[Other Term] OR Aged[Other Term]) OR “Frail Elderly”[Other Term]) OR “Oldest Old”[Other Term]) OR Nonagenarians[Other Term]) OR Nonagenarian[Other Term]) OR Octogenarians[Other Term]) OR Octogenarian[Other Term]) OR Centenarians[Other Term]) OR Centenarian[Other Term]) OR Elderly[Other Term])))
SCIELO search strategy
(((ab:(2019-nCoV)) OR (ab:(COVID-19)) OR (ab:(SARS-CoV-2)) OR (ab:(“Wuhan coronavirus”)) OR (ti:(2019-nCoV)) OR (ti:(COVID-19)) OR (ti:(SARS-CoV-2)) OR (ti:(“Wuhan coronavirus”)))) AND (((ab:(“Anciano de 80 o más Años”)) OR (ab:(Anciano)) OR (ab:(“Anciano Frágil”)) OR (ab:(“Ancianos de 80 Años o más”)) OR (ab:(“Ancianos de 80 Años y más”)) OR (ab:(“Ancianos de 80 o más Años”)) OR (ab:(Centenarios)) OR (ab:(Nonagenarios)) OR (ab:(Octogenarios)) OR (ab:(“Adulto Mayor”)) OR (ab:(Ancianos)) OR (ab:(“Persona Mayor”)) OR (ab:(“Persona de Edad”)) OR (ab:(“Personas Mayores”)) OR (ab:(“Personas de Edad”)) OR (ab:(“Salud de la Persona Anciana”)) OR (ab:(“Salud de la Persona Mayor”)) OR (ab:(“Salud de la Tercera Edad”)) OR (ab:(“Tercera edad”)) OR (ab:(Longevos)) OR (ti:(“Anciano de 80 o más Años”)) OR (ti:(Anciano)) OR (ti:(“Anciano Frágil”)) OR (ti:(“Ancianos de 80 Años o más”)) OR (ti:(“Ancianos de 80 Años y más”)) OR (ti:(“Ancianos de 80 o más Años”)) OR (ti:(Centenarios)) OR (ti:(Nonagenarios)) OR (ti:(Octogenarios)) OR (ti:(“Adulto Mayor”)) OR (ti:(Ancianos)) OR (ti:(“Persona Mayor”)) OR (ti:(“Persona de Edad”)) OR (ti:(“Personas Mayores”)) OR (ti:(“Personas de Edad”)) OR (ti:(“Salud de la Persona Anciana”)) OR (ti:(“Salud de la Persona Mayor”)) OR (ti:(“Salud de la Tercera Edad”)) OR (ti:(“Tercera edad”)) OR (ti:(Longevos))))
LILACS search strategy (af:((tw:(2019-nCoV)) OR (tw:(COVID-19)) OR (tw:(SARS-CoV-2)) OR (tw:(“new coronavirus”)) OR (tw:(“novel coronavirus”)) OR (tw:(“2019-novel coronavirus”)) OR (tw:(““COVID-19 pandemic””)) OR (tw:(““COVID-19 virus infection””)) OR (tw:(““coronavirus disease-19””)) OR (tw:(““2019-nCoV infection””)) OR (tw:(““2019-nCoV disease””)) OR (tw:(““Wuhan coronavirus””)) OR (tw:(““COVID-19 virus disease””)))) AND (af:((af:((tw:(aged)) OR (tw:(“Anciano de 80 o más Años”)) OR (tw:(Anciano)) OR (tw:(“Anciano Frágil”)) OR (tw:(“Ancianos de 80 Años o más”)) OR (tw:(“Ancianos de 80 Años y más”)) OR (tw:(“Ancianos de 80 o más Años”)) OR (tw:(“Centenarios”)) OR (tw:(“Nonagenarios”)) OR (tw:(“Octogenarios”)) OR (tw:(“Viejísimos”)) OR (tw:(““Adulto Mayor””)) OR (tw:(““Ancianos””)) OR (tw:(““Persona Mayor””)) OR (tw:(““Persona de Edad””)) OR (tw:(““Personas Mayores””)) OR (tw:(““Personas de Edad””)) OR (tw:(““Salud de la Persona Anciana””)) OR (tw:(““Salud de la Persona Mayor””)) OR (tw:(“Aged, 80 and over”)) OR (tw:(Aged)) OR (tw:(“Health of the Elderly”)) OR (tw:(“Frail Elderly”)) OR (tw:(“Oldest Old”)) OR (tw:(Nonagenarians)) OR (tw:(Nonagenarian)) OR (tw:(Octogenarians)) OR (tw:(Octogenarian)) OR (tw:(Centenarians)) OR (tw:(Centenarian)) OR (tw:(Elderly)) OR (tw:(““Tercera edad””)) OR (tw:(Longevos)) OR (tw:(“Anciano de 60 o más Años”)) OR (tw:(“Aged, 60 and over”)))) OR (af:((mh:(“Anciano de 80 o más Años”)) OR (mh:(Anciano)) OR (mh:(“Anciano Frágil”))))))

Features			Total cases	Outpatient management cases	Hospitalization management cases^Ç Ç in three cases, patients were initially discharged and followed by outpatient management. However, they were subsequently admitted to the hospital. After medical evaluation, 23 other cases were admitted to the hospital.	ICU management cases^* * Of the 27 cases, one patient was directly admitted to ICU, whereas 12 patients were initially admitted to the hospital and then transferred to ICU (n=3). SD: Standard deviation. IQR: interquartile range.
Number			27	3	26	13
Age, median (IQR**)			65 (63–70)	65 (63–66)	65 (63–67.8)	66 (63–69)
Age (%/n)
	60–69		74.1/20	100/3	76.9/20	76.9/10
	70–79		22.2/6	0	19.2/5	15.4/2
	≥80		3.7/1	0	3.8/1	7.7/1
Sex (%/n)
	Women		48.1/13	33.33/1	50/13	53.8/7
	Men		51.9/14	66.7/2	50/13	46.2/6
Possible city of infection (%/n)
	Wuhan-Hubei		63/17	66.7/2	65.4/17	61.5/8
	Other than Wuhan		29.6/8	33.3/1	30.8/8	30.8/4
	No data available		7.4/2	0	3.8/1	7.7/1
Critical times
	Contact and onset of symptoms	mean±SD	6.97±3.23	–	7.43±2.57	6.56±3.84
	Contact and onset of symptoms	n	15		7	8
	Onset of symptoms and medical evaluation	mean±SD	3.50 (1.25–7.75)^€ € do not present normal distribution according to the statistical test of Shapiro-Wilk (p<0.05), being expressed as median (IQR).	–	3 (1–4.75)^€ € do not present normal distribution according to the statistical test of Shapiro-Wilk (p<0.05), being expressed as median (IQR).	5.83±4.63
	Onset of symptoms and medical evaluation	n	24		12	12
	Onset of symptoms and hospital admission	mean±SD	6.00 (3.00–8.00)^€ € do not present normal distribution according to the statistical test of Shapiro-Wilk (p<0.05), being expressed as median (IQR).	–	6.09±5.17	7.08±3.94
	Onset of symptoms and hospital admission	n	23		11	12
	Onset of symptoms and appearance of dyspnea	mean±SD	7±5.29	–	4±6.08	7.75±5.08
	Onset of symptoms and appearance of dyspnea	n	15		12	3
Medical history (%/n)
	Arterial hypertension		37./9	–	–	38.5/5
	Coronary heart disease		3.7/1			0
	Heart failure		3.7/1			0
	Diabetes mellitus		14.8/4	–	–	15.4/2
	Chronic bronchitis	3.7/1	–	–	7.7/1
	Oncological disease^β β three patients had a history of oncological disease: multiple myeloma, thyroid cancer, and gastric cancer.		11.1/3	–	–	7.7/1
	Chronic kidney disease		7.4/2	–	–	7.7/1
	Non-nephrotic proteinuria		3.7/1	–	–	0
	Others^$		14.8/4			57.1/4
At least one comorbidity		51.8/14		–	–	53.8/7
Two or more comorbidities		22.2/6		33.3/1	19.2/5	7.7/1
Symptoms and Signs (%/n)
	Fever (%/n)^¶ ¶ six patients (n=6) who presented fever and chills.		88.9/24	–	92.3/24	85.7/6
	Maximum temperature mean±SD (n)		38 (37.7–39)^€ € do not present normal distribution according to the statistical test of Shapiro-Wilk (p<0.05), being expressed as median (IQR).	–	38.39±0.6 (9)	36.4±1.20 (2)
Maximum temperature (%/n)
	≤37.5		18.2/2	0	0	100/2
	37.51–38.3		36.4/4	0	44.4/4	0
	≥38.3		45.5/5	100/3	55.6/5	0
	Cough (%/n)		70.4/19	–	79.2/19	–
	Dry cough		31.6/6	–	–	–
	Not specified		68.4/13	–	–	–
	Dyspnea^Θ Θ respiratory distress symptoms were assessed in the first medical evaluation and throughout the disease process.		59.3/16	–	57.7/15	100/13
	Myalgia		25.9/7	–	26.9/7	30.8/4
	Chills		22.2/6	–	23.1/6	30.8/4
	Fatigue		22.6/6	–	23.1/6	0
	Dizziness		7.4/2	–	7.7/2	7.7/1
	Sore throat		7.4/2	–	8.7/2	0
	Diarrhea		7.4/2	–	7.7/2	15.4/2
	Rhinorrhea		3.7/1	–	4.3/1	0
	Other symptoms		22.2/6	–	19.2/5	7.7/1
	Syncope		3.7/1	–	3.8/1	0
	Headache		3.7/1	–	3.8/1	0
	Thoracic oppression		3.7/1	–	3.8/1	0
	Nausea or vomiting		7.4/2	–	3.8/1	7.7/1
	Back pain		3.7/1	–	3.8/1	0
Symptoms leading patients to seek medical care
	Fever		44.4/12	–	–	46.15/6
	Cough		14.8/4	–	–	7.69/1
	Dyspnea		7.4/2	–	–	15.38/2
	Fatigue		3.7/1	–	–	0
	Diarrhea		3.7/1	–	–	7.69/1
	Syncope		3.7/1	–	–	1
	Dizziness		3.7/1	–	–	7.69/1
	Myalgia		3.7/1	–	–	7.69/1
	Thoracic oppression		3.7/1	–	–	0

Characteristics		Upon admission (n=27)	During hospitalization (n=27)	During ICU stay (n=13)
Chest X-ray performed (%/n)		37/10	44.4/12	57.1/4
Chest X-ray parenchymal radiopacity (%/n)
	Consolidation	40/4	16.7/2	75/3
	Ground-glass opacification	10/1	58.3/7	25/1
	No radiopacity	30/3	0	0
Affected lung (%/n)
	Right lung	10/1	0	25/1
	Left lung	10/1	0	0
	Bilateral	40/4	100/12	75/3
Injury distribution (%/n)
	Peripheral	20/2	66.7/8	0
	Perihilar	10/1	8.3/1	0
	Both	10/1	0	25/1
Injury localization (%/n)
	Basal opacities	30/3	75/9	50/2
	Apical opacities	0	0	0
	Other locations	10/1	0	25/1
Other findings (%/n)
	Pleural effusion	0	58.3/7	25/1
	Nodular lesion	0	0	50/2
	Chest CT scan performed (%/n)	37/10	66.7/18	57.1/4
Affected lung (%/n)
	Right lung	20/2	11.1/2	0
	Left lung	10/1	0	0
	Bilateral	50/5	83.3/15	75/3
Injury localization (%/n)
	Central injuries	10/1	5.6/1	ND
	Peripheral lesions	20/2	61.1/11	ND
	Both	20/2	5.6/1	ND
Main parenchymal pattern
	Ground-glass Opacification	70/7	88.9/16	75/3
	Consolidation	10/1	5.6/1	0
	Reticular	0	0	0
	Mixed	0	0	25/1
Other findings (%/n)
	Nodular lesion	10/1	16.7/3	50/2
	Thickened interlobular	20/2	22.2/4	50/2
	Nonspecific injury margin	ND	11.1/2	ND
	Crazy-paving pattern	30/3	16.7/3	50/2
	Cystic lesion	ND	ND	25/1
	Pleural thickening	ND	16.7/3	50/2
	Pleural effusion	ND	44.4/8	25/1
	Lymphadenopathy	30/3	16.7/3	50/2

		Normal values	During hospitalization (n=26)	During ICU stay (n=7)
Laboratory values mean±SD (n)
	PaO₂/FiO₂ ratio	>400	157.75±68.26	81±7.07 (2)
	Hemoglobin (g/dl)	13–17.5	13 (5)	–
	Leukocytes count (*10^9/L)	3.5–9.5	4.61 (4.13–6.73)/17^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	17.54±5.87 (3)
	Lymphocytes count (*10^9/L)	1.10–3.20	0.72±0.28 (17)	0.42±0.08 (3)
	Neutrophils count (*10^9/L)	1.8–6.3	3.92±1.46	–
	Platelets count (*10^9/L)	150-450	137.46±37.87	–
	CD4 (cells/μL)	34–52	39.32±10.61	–
	CD8 (cells/μL)	21–39	17.28±5.80	–
	Myoglobin (ng/mL)	0–110	40.10 (32.7–111.9)/7^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–
	Troponin (ngmL)	0–0.1	0.012 (0.012–0.014)/(8)^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–
	Creatine phosphokinase -MB (ng/ml)	0–2.37	0.90 (0.23–42.00)/11^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–
	Lactate dehydrogenase (UI/L)	114.0–240.0	502±310.90 (14)	–
	Glutamic-oxaloacetic transaminase (GOT/AST) (UI/L)	5-40	33.6 (24.6–49.00)/13^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–
	Glutamic pyruvic transaminase (GPT/ALT) (UI/L)	5-40	26.5 (16.50–39.65)/13^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–
	Albumin (g/L)	40.0–55.0	38.28±2.99 (11)	–
	C-reactive protein (mg/L)	<10	58.26±34.42 (16)	208±93.24 (3)
	Creatinine (μmol/L)	58–110	81.90 (53.55–98.50)/13^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–
	Urea (mmol/L)	0.5-2.7	9.44±4.93 (12)	–
	Interleukin 6 (pg/mL)	<1.5	232.53±209.97 (3)	–
	D-dimer (mg/L)	<0.5	0.45 (0.30–0.60)/4^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–
	Procalcitonin (ng/mL)	0–0.5	0.09 (0.04–0.20)/8^€ € non-Gaussian distribution according to the Shapiro-Wilk statistical test (p<0.05), in such a way that they are expressed as median and interquartile range (IQR/n); NV: normal values.	–

Treatments (%/n)		During hospitalization (n=27)	Destination after hospitalization			During ICU stay (n=13)	Destination after ICU stay
Treatments (%/n)		During hospitalization (n=27)	Medical discharge	ICU	Not specified	During ICU stay (n=13)	Medical discharge	Death	Stay in ICU
Antibiotics		14.8/4	25/1	50/2	25/1	30.77/4	50/2	25/1	25/1
Antivirals		51.9/14	14.3/2	64.3/9	21.4/3	30.77/4	50/2	25/1	25/1
Lopinavir-Ritonavir		37.5/5	20/1	60/3	20/1	75/3	66.7/2	0	33.3/1
Oseltamivir		28.6/4	0	100/4	0	0	0	0	0
Ribavirin		50/7	0	85.7/6	14.3/1	0	0	0	0
Others		85.7/12	16.7/2	58.3/7	25/3	15.4/2	0	0	0
Interferon		57.1/8	0	75/6	25/2	0	0	0	0
Umifenovir		21.4/3	66.7/2	33.3/1	0	7.7/1	0	0	100/1
Abidor		7.14/1	0	0	100/1	0	0	0	0
Remdesivir		–	–	–	–	7.7/1	0	100/1	0
Antimalarial treatment
	Hydroxychloroquine	100/2	0	100/2	0	15.4/2	100/2	0	0
	Immunological treatment	14.8/4	50/2	25/1	25/1	23.1/3	66.7/2	0	33.3/1
	Gamma globulin	75/3	33.33/1	33.33/1	33.33/1	7.7/1	0	0	100/1
	Tocilizumab	25/1	100/1	0	0	–
	Convalescent plasma	–	–	–	–	15.4/2	100/2	0	0
Other treatments
	Chinese Traditional Medicine	11.1/3	33.33/1	33.33/1	33.33/1	7.7/1	0	0	100/1
	Abidor+”Chinese Traditional Medicine”+Methylprednisolone	33.3/1	0	0	100/1	0	0	0	0
	Lopinavir/Ritonavir/Umifenovir+Shufeng Jiedu (SFJDC)	66.67/2	50/1	50/1	0	100/1	0	0	100/1
	Methylprednisolone	23.1/3	33.33/1	0	33.7/1	15.4/2	100/2	0	0

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Alberto Salazar-Granara. El Corregidor Avenue, 1531 – Postal Code 012 Las Viñas, La Molina – Lima – Peru. E-mail: asalazarg@usmp.pe