从不同虚弱程度来看 COVID-19 的结局：更健康的老年人中存在超额死亡率。
Outcomes from COVID-19 across the range of frailty: excess mortality in fitter older people.
机构信息
Department of Medicine for the Elderly, University College London Hospitals NHS Foundation Trust, London, WC1E 7HB, UK.
Department of Population Science and Experimental Medicine, MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, UK.
出版信息
Eur Geriatr Med. 2020 Oct;11(5):851-855. doi: 10.1007/s41999-020-00354-7. Epub 2020 Jul 18.
PURPOSE
Our aim was to quantify the mortality from COVID-19 and identify any interactions with frailty and other demographic factors.
METHODS
Hospitalised patients aged ≥ 70 were included, comparing COVID-19 cases with non-COVID-19 controls admitted over the same period. Frailty was prospectively measured and mortality ascertained through linkage with national and local statutory reports.
RESULTS
In 217 COVID-19 cases and 160 controls, older age and South Asian ethnicity, though not socioeconomic position, were associated with higher mortality. For frailty, differences in effect size were evident between cases (HR 1.02, 95% CI 0.93-1.12) and controls (HR 1.99, 95% CI 1.46-2.72), with an interaction term (HR 0.51, 95% CI 0.37-0.71) in multivariable models.
CONCLUSIONS
Our findings suggest that (1) frailty is not a good discriminator of prognosis in COVID-19 and (2) pathways to mortality may differ in fitter compared with frailer older patients.
目的
我们旨在量化 COVID-19 死亡率，并确定其与脆弱性和其他人口统计学因素的任何相互作用。
方法
纳入年龄≥70 岁的住院患者，比较同期入院的 COVID-19 病例与非 COVID-19 对照。前瞻性测量脆弱性，并通过与国家和地方法定报告的联系来确定死亡率。
结果
在 217 例 COVID-19 病例和 160 例对照中，年龄较大和南亚族裔，而不是社会经济地位，与更高的死亡率相关。对于脆弱性，病例（HR 1.02，95%CI 0.93-1.12）和对照组（HR 1.99，95%CI 1.46-2.72）之间的效应大小差异明显，多变量模型中的交互项（HR 0.51，95%CI 0.37-0.71）。
结论
我们的研究结果表明：（1）脆弱性不是 COVID-19 预后的良好判别指标；（2）与较健康的脆弱老年患者相比，死亡率的途径可能不同。
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