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The global COVID-19 pandemic is a significant health concern worldwide. Although higher rates of infection and death have been seen among older adults, particularly in care facilities, the specific factors contributing to this increased risk remain unclear. In an effort to isolate these factors, the authors of this study analyzed records from a long-term elder care facility that was converted into a COVID-19 healthcare facility from March 15 to June 5, 2020. A total of 100 individuals were studied, with a median age of 85 years; 62% of the patients were female. A statistical analysis showed that being male, having a health condition that impedes self-care, and having low lymphocyte counts in the blood are all independently associated with increased risk of dying from COVID-19. In a secondary analysis, the authors compared two groups of patients: those receiving hydroxychloroquine and azithromycin and those receiving hydroxychloroquine alone or in combination with antibiotics other than azithromycin; the cardiovascular risk posed by the hydroxychloroquine + azithromycin combination led to the formation of the second group. Patients who did not receive hydroxychloroquine + azithromycin showed a higher COVID-19 mortality rate than those receiving that drug combination.
Limitations: The analysis did not address the potential for cardiovascular issues alone to cause increased risk in this group. It is also limited as a small, retrospective study of one elder care facility. The authors emphasize that only controlled clinical trials with a larger population can determine whether this treatment may be beneficial in a general population for prevention of COVID-19-associated death.