Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France.
Sorbonne Université, Inserm, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, 47-83, boulevard de l'hôpital, 75013 Paris, France.
Infect Dis Now. 2021 Jun;51(4):368-373. doi: 10.1016/j.idnow.2020.12.004. Epub 2021 Jan 18.
To describe clinical, biological, radiological presentation and W4 status in COVID-19 elderly patients.
All patients ≥ 70 years with confirmed SARS-CoV-2 infection and hospitalized in the Infectious Diseases department of the Pitié-Salpêtrière hospital, Paris, France, from March 1st to April 15th 2020 were included. The primary outcome was death four weeks after hospital admission. Data on demographics, clinical features, laboratory tests, CT-scan findings, therapeutic management and complications were collected.
All in all, 100 patients were analyzed, including 49 patients ≥ 80 years. Seventy percent had ≥2 comorbidities. Respiratory features were often severe as 48% needed oxygen support upon admission. Twenty-eight out of 43 patients (65%) with a CT-scan had mild to severe parenchymal impairment, and 38/43 (88%) had bilateral impairment. Thirty-two patients presented respiratory distress requiring oxygen support ≥ 6 liters/minute. Twenty-four deaths occurred, including 21 during hospitalization in our unit, 2 among the 8 patients transferred to ICU, and one at home after discharge from hospital, leading to a global mortality rate of 24% at W4. Age, acute renal failure and respiratory distress were associated with mortality at W4.
A substantial proportion of elderly COVID-19 patients with several comorbidities and severe clinical features survived, a finding that could provide arguments against transferring the most fragile patients to ICU.
描述 COVID-19 老年患者的临床、生物学、影像学表现和 W4 状态。
纳入所有 2020 年 3 月 1 日至 4 月 15 日期间在法国巴黎皮提-萨尔佩特里埃医院传染病科住院的年龄≥70 岁且确诊 SARS-CoV-2 感染的患者。主要结局为住院四周后的死亡。收集了人口统计学、临床特征、实验室检查、CT 扫描结果、治疗管理和并发症的数据。
共分析了 100 例患者，其中≥80 岁的患者 49 例。70%的患者合并≥2 种合并症。入院时呼吸症状常很严重，48%的患者需要氧疗支持。43 例中有 CT 扫描的患者中，28 例（65%）有轻至重度实质损害，38/43 例（88%）有双侧损害。32 例患者出现需要≥6 升/分钟氧疗支持的呼吸窘迫。共有 24 例死亡，包括在我们科室住院期间死亡的 21 例，转入 ICU 的 8 例中的 2 例，出院后在家死亡的 1 例，导致 W4 时的总死亡率为 24%。年龄、急性肾衰和呼吸窘迫与 W4 时的死亡率相关。
相当一部分合并多种合并症和严重临床特征的老年 COVID-19 患者存活，这一发现可能为不将最脆弱的患者转入 ICU 提供依据。
