Department of Anesthesiology and Intensive Care and Department of Biomedical and Clinical Sciences, Linköping University, S-58185, Linköping, Sweden.
Department of Orthopedics, Linköping University Hospital, Linköping, Sweden.
BMC Geriatr. 2021 Apr 20;21(1):262. doi: 10.1186/s12877-021-02176-z.
During the first pandemic wave, Sweden experienced a high mortality rate. Home healthcare reflects a group of people especially vulnerable to coronavirus disease 2019 (COVID-19). We aimed to evaluate the pattern of comorbidity and frailty in a group of individuals having fatal outcomes in home healthcare during the COVID-19 pandemic March to September 2020, and to assess the contribution of COVID-19 in the fatal outcomes.
A cohort of adults with confirmed COVID-19 diagnosis that deceased in home healthcare between March and September 2020 were analysed in a retrospective study comprising home healthcare in 136 facilities in one Swedish county. Main outcome measures were comorbidity and frailty.
One hundred fifty-five individuals (88 women, 67 men) aged 57-106 (median 88) years were included in the analysis. Nine had considerable frailty (ability to perform various activities of daily living but confined to bed or chair on occasion) and the remaining 146 had severe frailty (unable to perform activities of daily living and/or confined to bed or chair; dementia necessitating care). Three or more diagnoses besides COVID-19 were present in 142 individuals and another eight had two diagnoses in addition to COVID-19. In 20 (13%) individuals, COVID-19 was assessed as the principal cause of death, in 100 (64.5%) a contributing cause, and for the remaining 35 (22.5%) death was probably caused by another comorbidity. This seemed to change over the course of the COVID - 19 pandemic, with its contributing role decreasing from the middle of the summer.
Death in home healthcare during the first wave of the pandemic mostly affected individuals with severe frailty and comorbidity at very advanced ages. One fifth of the individuals who died in home health care had another cause than Covid-19.
Clinical Trials.gov NCT04642196 date 24/11/2020.
在第一波大流行期间，瑞典的死亡率很高。家庭保健反映了一组特别容易感染 2019 年冠状病毒病（COVID-19）的人群。我们旨在评估 2020 年 3 月至 9 月 COVID-19 大流行期间在家庭保健中死亡的一组个体的合并症和脆弱性模式，并评估 COVID-19 在致命结果中的作用。
对在 2020 年 3 月至 9 月期间在家庭保健中确诊 COVID-19 并死亡的成年人进行回顾性研究，该研究包含瑞典一个县的 136 个家庭保健机构。主要观察指标为合并症和脆弱性。
共纳入 155 名（88 名女性，67 名男性）年龄 57-106 岁（中位数 88 岁）的个体。9 人有相当大的脆弱性（能够进行各种日常生活活动，但偶尔会卧床或坐在椅子上），其余 146 人有严重的脆弱性（无法进行日常生活活动和/或卧床或坐在椅子上；需要护理的痴呆症）。除 COVID-19 外，142 人有 3 种或更多种诊断，另外 8 人除 COVID-19 外还有 2 种诊断。20 人（13%）被评估为 COVID-19 是主要死亡原因，100 人（64.5%）是促成因素，其余 35 人（22.5%）死亡可能由另一种合并症引起。这似乎随着 COVID-19 大流行的发展而发生变化，其促成作用从夏中开始下降。
大流行第一波期间在家庭保健中死亡的患者主要是年龄非常大且有严重脆弱性和合并症的个体。在家庭保健中死亡的个体中，有五分之一的死亡原因不是新冠病毒。
ClinicalTrials.gov NCT04642196 日期 2020 年 11 月 24 日。
