Malézieux-Picard Astrid, Ferrer Soler Cecilia, De Macedo Ferreira David, Gaud-Luethi Emilie, Serratrice Christine, Mendes Aline, Zekry Dina, Gold Gabriel, Lobrinus Johannes Alexander, Arnoux Grégoire, Serra Fulvia, Prendki Virginie
Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland.
Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland.
J Clin Med. 2021 Mar 24;10(7):1337. doi: 10.3390/jcm10071337.
Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood.
We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and positive for SARS-CoV-2. Full body autopsy and correlation with clinical findings and suspected causes of death were done.
Autopsies were performed in 12 patients (median age 85 years; median of 4 comorbidities, mainly hypertension and cardiovascular disease). All cases showed exudative or proliferative phases of alveolar damage and/or a pattern of organizing pneumonia. Causes of death were concordant in 6 cases (50%), and undetected diagnoses were found in 6. Five patients died from hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19), five had another associated diagnosis and two died from alternative causes. Deaths that occurred in the second week were related to SARS-CoV-2 pneumonia whereas those occurring earlier were related mainly to heart failure and those occurring later to complications.
Although COVID-19 hypoxemic respiratory failure was the most common cause of death, post-mortem pathological examination revealed that acute decompensation from chronic comorbidities during the first week of COVID-19 and complications in the third week contributed to mortality.
对于老年2019冠状病毒病（SARS-CoV-2）感染患者的死亡机制和原因仍了解不足。
我们进行了一项回顾性单中心研究，对75岁及以上因急性病住院且SARS-CoV-2检测呈阳性的患者进行临床病历审查和尸检。进行了全身尸检，并将其与临床发现及疑似死亡原因相关联。
对12例患者进行了尸检（中位年龄85岁；中位合并症数为4种，主要为高血压和心血管疾病）。所有病例均显示肺泡损伤的渗出期或增殖期和/或机化性肺炎模式。6例（50%）的死亡原因一致，6例发现了未被检测到的诊断。5例患者死于2019冠状病毒病（COVID-19）导致的低氧性呼吸衰竭，5例有其他相关诊断，2例死于其他原因。第二周发生的死亡与SARS-CoV-2肺炎有关，而较早发生的死亡主要与心力衰竭有关，较晚发生的死亡与并发症有关。
尽管COVID-19低氧性呼吸衰竭是最常见的死亡原因，但尸检病理检查显示，COVID-19第一周慢性合并症的急性失代偿和第三周的并发症导致了死亡。
