JMIR Publications

ABSTRACT

Background:

Marked by high mortality rates on a global scale, with disease mortality being notably focused among the elderly, the COVID-19 pandemic has become a significant health crisis. Despite the numerous publications on COVID-19 mortality among the elderly, there is still a gap in knowledge when dealing with centenarians, as there is no systematic review and meta-analysis that summarizes COVID-19 mortality in centenarians globally.

Objective:

This study aims systematically review and synthesize global evidence on COVID-19 mortality rates among centenarians and the elderly population worldwide, whether residing in long-term health facility (LTHF), hospital, or their home.

Methods:

An automated search was conducted on the following databases: PubMed, Scopus, Web of Science. Observational studies, both cohort and case-control were selected. Quality assessment of the selected studies was assessed based on Joanna Briggs Institute (JBI) critical appraisal tool for observational cohort and case-control studies. Three independent authors conducted the searches, and any possible disagreements were resolved by consensus. A meta-analysis of mortality proportions was conducted among studies to calculate the proportion, logit and arcsine proportions for all studies included in our meta-analyses. Heterogeneity between study was evaluated with a significance p=0.05. An assessment of heterogeneity with I2 value was presented using random effects DL, DerSimonian-Laird method. Odds ratio (OR) and 95% CI for dichotomous data outcome were determined. Weighted mean risk difference (RD) and 95% CI were calculated for continuous variables. The meta-analysis was conducted using R software version 4.4.2.

Results:

A total of four studies were included in our systematic review and meta-analysis. Of the included studies, three are retrospective cohort and one observational retrospective case-control. As for study group size, one cohort study was conducted on a population of less than 1000 participants, two studies, one cohort and one case-control, involved more than 10,000 participants and one cohort study included more than 6 million participants.

Conclusions:

This study has significant potential. Given the consensus that the elderly population, let alone centenarians, is the most vulnerable demographic to serious outcomes and deaths during pandemics, addressing these gaps is crucial for the informed development of public policies, enabling countries to minimize the impacts on this population, particularly during health crises such as the COVID-19 pandemic. Clinical Trial: PROSPERO CRD645150, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=645150