Department of Internal Medicine.
Department of Infectious Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
Medicine (Baltimore). 2021 Feb 26;100(8):e24750. doi: 10.1097/MD.0000000000024750.
To investigate the clinical characteristics and outcome of octogenarians with covid-19.This is a observational, retrospective, descriptive study.Consecutive patients aged >80 years who were admitted for covid-19 pneumonia during a 6 weeks period (March 20-April 30, 2020).Illness severity on admission was classified according to World Health Organization (WHO) criteria: mild, moderate, severe, and critical. Data collected included demographics, presenting symptoms, radiological and laboratory findings, comorbidities, functional status, treatment, and clinical outcome.There were 159 patients (52.2% women) with a median age of 85.99 (IQR: 80-98). The median Barthel index was 90 (40-100) and Charlson index was 5 (5-6). Most common presenting symptoms were fever, dyspnea, and cough. Patients had mild (8.2%), moderate (52.2%), or severe (39.6%) illness according to WHO criteria. A bilateral pulmonary involvement was seen in 86% of patients. Laboratory analysis revealed increased serum concentrations of inflammatory parameters (C-reactive protein, ferritin, lactate dehydrogenase, and D-dimer) with an abnormal lymphocyte count [0.88 × 109/L (0.5)]. Treatments included corticosteroids in 37%, and biological therapies in 17.6%. Fifty three (33.3%) patients died during hospitalization, with a median time from admission to death of 3 (IQR 1-6) days. Mortality was higher in men (55%). Deceased patients had a significantly higher frequency of dyspnea, increased inflammatory parameters, and illness severity compared to survivors.One-third of octogenarians with covid-19 died during hospitalization and most had bilateral lung involvement. A further knowledge of the characteristics and outcome of this population may assist clinicians in the decision-making process in these patients.
研究 80 岁以上新冠患者的临床特征和转归。这是一项观察性、回顾性、描述性研究。连续纳入 2020 年 3 月 20 日至 4 月 30 日期间因新冠肺炎住院的 80 岁以上患者。入院时疾病严重程度根据世界卫生组织(WHO)标准进行分类:轻症、中度、重症和危重症。收集的数据包括人口统计学、临床表现、影像学和实验室检查结果、合并症、功能状态、治疗和临床转归。共纳入 159 例患者(52.2%为女性),中位年龄为 85.99 岁(IQR:80-98)。中位巴氏指数为 90 分(40-100),Charlson 指数为 5 分(5-6 分)。最常见的临床表现为发热、呼吸困难和咳嗽。根据 WHO 标准,患者的疾病程度为轻症(8.2%)、中度(52.2%)或重症(39.6%)。86%的患者存在双侧肺部受累。实验室分析显示炎症参数(C 反应蛋白、铁蛋白、乳酸脱氢酶和 D-二聚体)血清浓度升高,淋巴细胞计数异常[0.88×109/L(0.5)]。治疗包括皮质类固醇 37%,生物治疗 17.6%。53 例(33.3%)患者住院期间死亡,中位自入院至死亡时间为 3(IQR 1-6)天。男性死亡率(55%)更高。与存活者相比,死亡患者呼吸困难的频率更高,炎症参数更高,疾病严重程度更高。三分之一的 80 岁以上新冠患者住院期间死亡,大多数患者存在双侧肺部受累。进一步了解这一人群的特征和转归,可能有助于临床医生在这些患者的决策过程中提供参考。