Differences in characteristics and outcomes of older patients hospitalized for COVID-19 after introduction of vaccination.

Purpose: The aim of the present study was to investigate characteristics and outcomes in vaccinated and unvaccinated older patients hospitalized for COVID-19 infection. Methods: A retrospective multicentre cohort study among patients aged ≥70 years hospitalized for COVID-19 infection. Results: 263 vaccinated and 82 unvaccinated patients were included. Vaccinated patients were older (median age 79 vs. 76 years; p<0.001), had more comorbidities (median Charlson Comorbidity Index (CCI) 2 vs. 1; p0.016) and were frailer (Clinical Frailty Scale (CFS) ≥4 68% vs. 49%; p0.015). Vaccinated patients were admitted earlier after symptom onset (median 5 days vs. 7 days) but were equally ill at time of hospital admission. After correction for frailty, comorbidity and disease severity, risk of in-hospital mortality was three times lower for vaccinated patients (HR 0.30 95% CI 0.16-0.56; p<0.001) compared to unvaccinated patients. Conclusion: Compared to older unvaccinated patients hospitalized for COVID-19, vaccinated patients were frailer, had more comorbidities but, independent of these factors, a three times lower risk for in-hospital mortality. These findings may trigger pro-active geriatric advance care planning, aimed toward early rehabilitation.