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合并症对 COVID-19 老年患者的影响:中国四川感染 COVID-19 的老年患者的临床特征。

Effects of Comorbidities on the Elderly Patients with COVID-19: Clinical Characteristics of Elderly Patients Infected with COVID-19 from Sichuan, China.

机构信息

Jin-hui Wu, National Center for Geriatrics Clinical Medicine Research, Department of Geriatrics and Gerontology, West China Hospital, Sichuan University, Chengdu, 610041, China,

出版信息

J Nutr Health Aging. 2021;25(1):18-24. doi: 10.1007/s12603-020-1486-1.

Abstract

OBJECTIVES

The co-occurrence of chronic diseases in the elderly is a common problem. However, the relationship between comorbidities and the prognosis of elderly patients with COVID-19 was not clear. This study was supposed to describe the clinical characteristics of elderly patients with COVID-19 infection from Sichuan province and the effects of comorbidity.

DESIGN

A retrospective study.

SETTINGS AND PARTICIPANTS

COVID-19 patients from Public Health Clinical Center of Chengdu between December 16, 2019 and February 26, 2020 were included in this study. Patients were divided into elderly group (≥60 years old) and non-elderly group (< 60 years old).

RESULTS

Elderly patients with COVID-19 indicated relatively higher proportion of comorbidities, and the most common were atherosclerotic cardiovascular disease (56.5%), hypertension (43.5%) and chronic pulmonary disease (21.7%). The proportion of severe cases was higher in elderly group than that in non-elderly group (73.9% and 42.2%, respectively, P=0.012). During hospitalization, elderly patients indicated relatively higher proportion of complications, such as shock (21.7%), respiratory failure (21.7%). The proportion of patients with a decreased number of CD8+ lymphocytes (82.6%) and B lymphocytes (77.8%) in elderly patients was significantly higher than that in non-elderly group (48.9% and 44.8%, respectively). All 3 deaths were elderly patients with comorbidities and the cell counts of T lymphocyte subsets, B and NK cells of them were significantly decreased at admission.

CONCLUSIONS

Elderly patients with COVID-19 had a high proportion of severe cases and comorbidities, more likely to show low immune function, and indicate higher proportion of complications.

摘要

目的

老年人慢性病共存是一个常见问题。然而,合并症与 COVID-19 老年患者预后之间的关系尚不清楚。本研究旨在描述来自四川省的 COVID-19 老年患者的临床特征及合并症的影响。

设计

回顾性研究。

地点和参与者

纳入 2019 年 12 月 16 日至 2020 年 2 月 26 日期间成都市公共卫生临床医疗中心的 COVID-19 患者。患者分为老年组(≥60 岁)和非老年组(<60 岁)。

结果

COVID-19 老年患者合并症的比例相对较高,最常见的是动脉粥样硬化性心血管疾病(56.5%)、高血压(43.5%)和慢性肺部疾病(21.7%)。老年组重症病例的比例高于非老年组(分别为 73.9%和 42.2%,P=0.012)。住院期间,老年患者出现并发症的比例相对较高,如休克(21.7%)、呼吸衰竭(21.7%)。老年患者 CD8+淋巴细胞(82.6%)和 B 淋巴细胞(77.8%)数量减少的比例明显高于非老年患者(分别为 48.9%和 44.8%)。所有 3 例死亡均为合并症的老年患者,入院时他们的 T 淋巴细胞亚群、B 细胞和 NK 细胞计数明显降低。

结论

COVID-19 老年患者重症和合并症的比例较高,更有可能表现出低免疫功能,并发症的比例较高。

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