Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania.
Internal Medicine, Rowan University SOM, Stratford, New Jersey.
J Am Geriatr Soc. 2020 May;68(5):926-929. doi: 10.1111/jgs.16472. Epub 2020 Apr 20.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that causes COVID-19 infection, has recently emerged and caused a deadly pandemic. Studies have shown that this virus causes worse outcomes and a higher mortality rate in older adults and those with comorbidities such as hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and chronic kidney disease (CKD). A significant percentage of older American adults have these diseases, putting them at a higher risk of infection. Additionally, many adults with hypertension, diabetes, and CKD are placed on angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers. Studies have shown that these medications upregulate the ACE-2 receptor, the very receptor that the SARS-CoV-2 virus uses to enter host cells. Although it has been hypothesized that this may cause a further increased risk of infection, more studies on the role of these medications in COVID-19 infections are necessary. In this review, we discuss the transmission, symptomatology, and mortality of COVID-19 as they relate to older adults, and possible treatments that are currently under investigation. J Am Geriatr Soc 68:926-929, 2020.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是一种引起 COVID-19 感染的新型病毒,最近出现并导致了致命的大流行。研究表明,这种病毒在老年人和患有高血压、心血管疾病、糖尿病、慢性呼吸道疾病和慢性肾脏病(CKD)等合并症的人群中会导致更严重的后果和更高的死亡率。相当一部分美国老年人患有这些疾病,使他们面临更高的感染风险。此外,许多患有高血压、糖尿病和 CKD 的成年人都在服用血管紧张素转换酶(ACE)抑制剂和血管紧张素 II 受体阻滞剂。研究表明,这些药物会上调 ACE-2 受体,而 SARS-CoV-2 病毒正是利用该受体进入宿主细胞。虽然有人假设这可能会导致感染风险进一步增加,但仍需要更多研究来探讨这些药物在 COVID-19 感染中的作用。在这篇综述中,我们讨论了 COVID-19 在与老年人相关的传播、症状和死亡率,以及目前正在研究的可能治疗方法。J Am Geriatr Soc 68:926-929, 2020.