A Retrospective Observational Study Evaluating COVID-19 Mortality and Morbidity in a Rural ICU Among People Over and Under 65.

Background The literature surrounding COVID-19 mortality in the elderly compellingly leans towards the elderly faring worse. The populations of such literature often combined the rural and urban populations or simply discounted the rural population altogether. Anecdotal evidence suggests that this stigma is misplaced and that the elderly are not always at risk of the worst health outcomes. Method SARS-CoV-2-positive patients who were admitted to the ICU of Hatta Hospital were included in the study. They were split into two groups, those under and those over the age of 65. Percentage mortality, morbidity using Acute Physiology and Chronic Health Evaluation II (APACHE II), and duration of hospital admission were assessed in the two groups, and statistical analysis was performed. Results Seventy-two patients were deemed eligible for inclusion. Percentage mortality of the total population was 16.67% (N=12). In the under 65's arm the mortality percentage was 12.5% and the percentage mortality of the over 65's was 21.9% (N=7); chi-squared=1.13 (p=0.29). There was no statistical significance between mortality in the two arms. The global average time to discharge was 20.64 ± 1.98 days. The average time to discharge in the under-65's was 19.83± 2.64 days; the average time to discharge in the over-65 group was 21.66 ± 3.04 days; p= 0.65. The global average APACHE II score was 10.52 ± 0.77. The mean APACHE II score for the under 65's arm was 8.24 ± 0.95 while the mean APACHE II score for the over 65's was calculated at 13.2 ± 1.04: p=0.0008. Conclusion Overall, mortality was not significantly different, nor was their duration of stay. There was a significant difference in their morbidity; however, both groups had similar healthcare outcomes. The elderly did not face worse health outcomes than their younger counterparts. There is a gap in the literature discussing rural healthcare.