Respiratory tract infection in centenarians

Abstract

Introduction/Aim: Centenarians (age ≥ 99 years old) represent individuals who have achieved the extreme of age. Respiratory tract infections are common and pose a threat to their longevity. There is limited data on how this group responds to illness. This is a 3 year retrospective review of centenarians presenting to our institution with polymerase chain reaction (PCR) confirmed respiratory tract infections.

Methods: All positive respiratory multiplex PCR results (detects 10 viruses and 4 bacteria) were reviewed from 2016 to 2019 in adults ≥ 99 years. All samples were taken from the nasopharynx.

Results: 23 patients with 24 positive results were identified. The median age was 100.0 (IQR 99.6 – 100) years and 17% were male. Before admission, 59% of patients resided at home while the rest were from long-term residential care facilities. Chronic kidney disease was the most common co-morbidity (78%), followed by hypertension (74%), cognitive impairment and cardiovascular disease (43% each). There was low prevalence of past smoking (4%) or pulmonary disease (17%). The median length of hospital stay was 6.37 (4.38 – 22.7) days. Delirium complicated 30% of admissions. The most prevalent pathogens were Influenza A (35%), rhino/enterovirus (22%) and respiratory syncytial virus (17%). 3 deaths were observed. 61% of patients were discharged to their original abode, while the other 22% required further stay in a sub-acute care facility.

Conclusion: In this centenarian group with high rates of co-morbidities, the mortality rate following a viral respiratory tract infection was modest at 13%. Most patients were discharged back to their original dwelling. Further studies into this group may provide insight to their responses to respiratory infections.