因 COVID-19 在养老院死亡-症状发生的性别差异。
Dying from COVID-19 in nursing homes-sex differences in symptom occurrence.
机构信息
Department of Radiation Sciences, Umeå University, SE-90187, Umeå, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
出版信息
BMC Geriatr. 2021 May 6;21(1):294. doi: 10.1186/s12877-021-02228-4.
BACKGROUND
Coronavirus disease 2019 (COVID-19), is a disease with diverse presentation. Several studies have shown different occurrence of symptoms for women and men, but no studies have been found examining sex differences in clinical presentation for nursing home residents dying from COVID-19. The objective of this study was to describe sex and age differences and the impact of a dementia diagnosis on symptom occurrence during the last week in life for persons dying from COVID-19 in nursing homes.
METHODS
This is a population-based retrospective study based on data from the Swedish Register of Palliative Care. A total of 1994 residents aged 65 or older who died from COVID-19 in nursing homes were identified. The impact of sex, age and a dementia diagnosis on six different symptoms was analysed using chi2-test and multivariate logistic regression.
RESULTS
Residents dying from COVID-19 were more often men (p < .002). Men more often had dyspnoea and death rattles (p < .001). Nausea was more common in women (p < .001). No sex differences in the occurrence of pain, anxiety or confusion were seen. Dyspnoea and nausea were less commonly reported in residents with dementia (p < .001).
CONCLUSIONS
We found sex differences in symptom presentation for fatal COVID-19 in nursing home settings which remained after adjusting for age. Residents with a dementia diagnosis had fewer symptoms reported before death compared to those without dementia. Clinical presentation of fatal COVID-19 differs between women and men in nursing homes. Residents with fatal COVID-19 present with more unspecific and less prominent symptoms when also suffering from dementia.
背景
2019 年冠状病毒病（COVID-19）是一种表现多样的疾病。多项研究表明，女性和男性的症状发生情况不同，但尚未发现研究检查死于 COVID-19 的养老院居民的临床表现中的性别差异。本研究的目的是描述性别和年龄差异，以及痴呆症诊断对死于 COVID-19 的养老院居民在生命最后一周出现症状的影响。
方法
这是一项基于瑞典姑息治疗登记处数据的基于人群的回顾性研究。确定了 1994 名年龄在 65 岁或以上、死于养老院 COVID-19 的居民。使用卡方检验和多变量逻辑回归分析性别、年龄和痴呆症诊断对六种不同症状的影响。
结果
死于 COVID-19 的居民中男性居多（p<0.002）。男性更常出现呼吸困难和死亡喘息（p<0.001）。女性更常出现恶心（p<0.001）。疼痛、焦虑或意识混乱的发生无性别差异。痴呆症患者呼吸困难和恶心的报告较少（p<0.001）。
结论
我们发现，在调整年龄后，在养老院环境中 COVID-19 致死患者的症状表现存在性别差异。与没有痴呆症的患者相比，痴呆症诊断患者在死亡前报告的症状较少。在养老院中，致命 COVID-19 的临床表现在女性和男性之间存在差异。患有致命 COVID-19 的居民同时患有痴呆症时，出现的症状更为不明确且不明显。
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