Mostaza Jose M, García-Iglesias Francisca, González-Alegre Teresa, Blanco Francisco, Varas Marta, Hernández-Blanco Clara, Hontañón Victor, Jaras-Hernández María J, Martínez-Prieto Mónica, Menéndez-Saldaña Araceli, Cachán María L, Estirado Eva, Lahoz Carlos
Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.
Departments of Internal Medicine, Hospital Carlos III, Madrid, Spain.
Arch Gerontol Geriatr. 2020 Nov/Dec;91:104204. doi: 10.1016/j.archger.2020.104204. Epub 2020 Jul 27.
Older subjects have a higher risk of COVID-19 infection and a greater mortality. However, there is a lack of studies evaluating the characteristics of this infection at advanced age.
We studied 404 patients ≥ 75 years (mean age 85.2 ± 5.3 years, 55 % males), with PCR-confirmed COVID-19 infection, attended in two hospitals in Madrid (Spain). Patients were followed-up until they were discharged from the hospital or until death.
Symptoms started 2-7 days before admission, and consisted of fever (64 %), cough (59 %), and dyspnea (57 %). A total of 145 patients (35.9 %) died a median of 9 days after hospitalization. In logistic regression analysis, predictive factors of death were age (OR 1.086; 1.015-1.161 per year, p = 0.016), heart rate (1.040; 1.018-1.061 per beat, p < 0.0001), a decline in renal function during hospitalization (OR 7.270; 2.586-20.441, p < 0.0001) and worsening dyspnea during hospitalization (OR 73.616; 30.642-176.857, p < 0.0001). Factors predicting survival were a female sex (OR 0.271; 0.128-0.575, p = 0.001), previous treatment with RAAS inhibitors (OR 0.459; 0.222-0.949, p = 0.036), a higher oxygen saturation at admission (OR 0.901; 0.842-0.963 per percentage point increase, p = 0.002), and a greater platelet count (OR 0.995; 0.991-0.999 per 10/L, p = 0.025).
Elderly patients with COVID-19 infection have a similar clinical course to younger individuals. Previous treatment with RAAS inhibitors, and demographic, clinical and laboratory data influence prognosis.
老年受试者感染新型冠状病毒肺炎(COVID-19)的风险更高,死亡率也更高。然而,目前缺乏评估高龄人群感染该病毒特征的研究。
我们研究了404例年龄≥75岁(平均年龄85.2±5.3岁,55%为男性)、经聚合酶链反应(PCR)确诊为COVID-19感染的患者,这些患者来自西班牙马德里的两家医院。对患者进行随访,直至出院或死亡。
症状在入院前2至7天出现,包括发热(64%)、咳嗽(59%)和呼吸困难(57%)。共有145例患者(35.9%)在住院中位时间9天后死亡。在逻辑回归分析中,死亡的预测因素包括年龄(比值比[OR]1.086;每年1.015至1.161,p = 0.016)、心率(1.040;每搏1.018至1.061,p < 0.0001)、住院期间肾功能下降(OR 7.270;2.586至20.441,p < 0.0001)以及住院期间呼吸困难加重(OR 73.616;30.642至176.857,p < 0.0001)。生存的预测因素包括女性(OR 0.271;0.128至0.575,p = 0.001)、既往使用肾素-血管紧张素-醛固酮系统(RAAS)抑制剂治疗(OR 0.459;0.222至0.949,p = 0.036)、入院时较高的血氧饱和度(OR 0.901;每增加一个百分点0.842至0.963,p = 0.002)以及较高的血小板计数(OR 0.995;每10/L 0.991至0.999,p = 0.025)。
老年COVID-19感染患者的临床病程与年轻患者相似。既往使用RAAS抑制剂治疗以及人口统计学、临床和实验室数据会影响预后。