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老年和年轻 COVID-19 患者的临床特征和结局比较。

A Comparison of Clinical Characteristics and Outcomes in Elderly and Younger Patients with COVID-19.

机构信息

Intensive Care Unit, Zhejiang Hospital, Hangzhou, Zhejiang, China (mainland).

Intensive Care Unit, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2020 Jul 28;26:e925047. doi: 10.12659/MSM.925047.

Abstract

BACKGROUND The aim of this study was to describe the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) and compare these parameters in an elderly group with those in a younger group. MATERIAL AND METHODS This retrospective, single-center observational study included 69 hospitalized patients with laboratory-confirmed COVID-19 from a tertiary hospital in Wuhan, China, between January 14, 2020, and February 26, 2020. Epidemiological, demographic, clinical, and laboratory data, as well as treatments, complications, and outcomes were extracted from electronic medical records and compared between elderly patients (aged ≥60 years) and younger patients (aged <60 years). Patients were followed until March 19, 2020. RESULTS Elderly patients had more complications than younger patients, including acute respiratory distress syndrome (ARDS; 9/25, 36% vs. 5/44, 11.4%) and cardiac injury (7/25, 28% vs. 1/44, 2.3%), and they were more likely to be admitted to the intensive care unit (6/25, 24% vs. 2/44, 4.5%). As of March 19, 2020, 60/69 (87%) of the patients had been discharged, 6/69 (8.7%) had died, and 3/69 (4.3%) remained in the hospital. Of those who were discharged or died, the median duration of hospitalization was 13.5 days (interquartile range, 10-18 days). CONCLUSIONS Elderly patients with confirmed COVID-19 were more likely to develop ARDS and cardiac injury than younger patients and were more likely to be admitted to the intensive care unit. In addition to routine monitoring and respiratory support, cardiac monitoring and supportive care should be a focus in elderly patients with COVID-19.

摘要

背景

本研究旨在描述 2019 年冠状病毒病(COVID-19)患者的临床特征和结局,并比较老年组与年轻组的这些参数。

材料与方法

本回顾性、单中心观察性研究纳入了 2020 年 1 月 14 日至 2 月 26 日期间,中国武汉一家三级医院的 69 例实验室确诊 COVID-19 住院患者。从电子病历中提取流行病学、人口统计学、临床和实验室数据以及治疗、并发症和结局,并在老年患者(年龄≥60 岁)和年轻患者(年龄<60 岁)之间进行比较。患者随访至 2020 年 3 月 19 日。

结果

老年患者比年轻患者更易发生并发症,包括急性呼吸窘迫综合征(ARDS;25 例中的 9 例,36% vs. 44 例中的 5 例,11.4%)和心脏损伤(25 例中的 7 例,28% vs. 44 例中的 1 例,2.3%),且更易入住重症监护病房(25 例中的 6 例,24% vs. 44 例中的 2 例,4.5%)。截至 2020 年 3 月 19 日,69 例患者中有 60 例(87%)出院,6 例(8.7%)死亡,3 例(4.3%)仍住院。出院或死亡患者的中位住院时间为 13.5 天(四分位距,10-18 天)。

结论

确诊 COVID-19 的老年患者比年轻患者更易发生 ARDS 和心脏损伤,且更易入住重症监护病房。除常规监测和呼吸支持外,心脏监测和支持性治疗应成为 COVID-19 老年患者的关注重点。

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