Neumann-Podczaska Agnieszka, Al-Saad Salwan R, Karbowski Lukasz M, Chojnicki Michal, Tobis Slawomir, Wieczorowska-Tobis Katarzyna
1Geriatrics Unit, Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.
2Department of Biology and Environmental Protection, Poznan University of Medical Sciences, Poznan, Poland.
Aging Dis. 2020 Jul 23;11(4):988-1008. doi: 10.14336/AD.2020.0620. eCollection 2020 Jul.
The SARS-CoV-2 tendency to affect the older individuals more severely, raises the need for a concise summary isolating this age population. Analysis of clinical features in light of most recently published data allows for improved understanding, and better clinical judgement. A thorough search was performed to collect all articles published from 1st of January to 1st of June 2020, using the keywords and followed by the generic terms , or . The quality assessment of studies and findings was performed by an adaptation of the STROBE statement and CERQual approach. Excluding duplicates, a total of 1598 articles were screened, of which 20 studies were included in the final analysis, pertaining to 4965 older COVID-19 patients (≥60 years old). Variety in symptoms was observed, with fever, cough, dyspnea, fatigue, or sputum production being the most common. Prominent changes in laboratory findings consistently indicated lymphopenia and inflammation and in some cases organ damage. Radiological examination reveals ground glass opacities with occasional consolidations, bilaterally, with a possible peripheral tendency. An evident fraction of the elderly population (25.7%) developed renal injury or impairment as a complication. Roughly 71.4% of the older adults require supplementary oxygen, while invasive mechanical ventilation was required in almost a third of the reported hospitalized older individuals. In this review, death occurred in 20.0% of total patients with a recorded outcome (907/4531). Variability in confidence of findings is documented. Variety in symptom presentation is to be expected, and abnormalities in laboratory findings are present. Risk for mortality is evident, and attention to the need for supplementary oxygen and possible mechanical ventilation is advised. Further data is required isolating this age population. Presented literature may allow for the construction of better predictive models of COVID-19 in older populations.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）对老年个体影响更为严重的倾向，增加了对这一年龄段人群进行简要总结的必要性。根据最新发表的数据对临床特征进行分析，有助于更好地理解并做出更优的临床判断。我们进行了全面检索，以收集2020年1月1日至6月1日发表的所有文章，使用的关键词以及通用术语包括 、 ，后面跟着 、 或 。通过改编的加强流行病学观察性研究报告（STROBE）声明和证据质量和推荐强度分级（CERQual）方法对研究及结果进行质量评估。排除重复文章后，共筛选了1598篇文章，其中20项研究纳入最终分析，涉及4965名老年2019冠状病毒病（COVID-19）患者（≥60岁）。观察到症状多样，发热、咳嗽、呼吸困难、疲劳或咳痰最为常见。实验室检查结果的显著变化始终显示淋巴细胞减少和炎症，在某些情况下还显示器官损伤。影像学检查显示双侧磨玻璃影，偶见实变，可能有外周分布倾向。相当一部分老年人群（25.7%）出现肾损伤或肾功能损害并发症。约71.4%的老年人需要补充氧气，而在报告住院的老年人中，近三分之一需要有创机械通气。在本综述中，有记录结果的患者中20.0%死亡（907/4531）。记录了研究结果可信度的差异。症状表现多样是可以预期的，实验室检查结果也存在异常。死亡风险明显，建议关注补充氧气的需求以及可能需要的机械通气。需要更多数据来单独研究这一年龄段人群。现有文献可能有助于构建更优的老年人群COVID-19预测模型。
