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日本 COVID-19 老年患者的特征和结局。

Characteristics and outcomes of older patients with coronavirus disease 2019 in Japan.

机构信息

Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

出版信息

Geriatr Gerontol Int. 2021 Aug;21(8):629-635. doi: 10.1111/ggi.14207. Epub 2021 Jun 9.

Abstract

AIM

The epidemiological characteristics, in-hospital treatments and outcomes of coronavirus disease 2019 among older patients have not been fully evaluated in Japan.

METHODS

In this retrospective observational study carried out in Osaka Prefecture, Japan, we enrolled patients aged ≥60 years with laboratory-confirmed coronavirus disease 2019 from January to November 2020. The main outcome was mortality during the observation period, based on the Infectious Diseases Control Law. Cox regression analysis was used to evaluate the association between epidemiological factors and mortality among older patients with coronavirus disease 2019.

RESULTS

Older patients accounted for 21.5% (3192/14 846) of the registered patients with coronavirus disease 2019. The number of patients according to age was as follows: 60-69 years, 1140 (35.7%); 70-79 years, 1058 (33.1%); 80-89 years, 749 (23.5%); and ≥90 years, 245 (7.7%). The proportion of deaths during the observation period was 8.5% (271/3192). The proportion of deaths increased with increasing age category (from 1.9% to 20.4%, P for trend <0.001). In multivariable Cox regression analysis, patients aged 70-79, 80-89 and ≥90 years had higher hazard ratios and 95% confidence intervals of death (2.62 [1.63-4.23], 5.99 [3.77-9.50] and 10.24 [6.03-17.40], respectively) than those aged 60-69 years. Factors such as male sex, presence of comorbidities, cluster cases in medical institutions and moderate/severe symptoms at diagnosis were also associated with mortality.

CONCLUSIONS

This study shows the epidemiological characteristics of older patients with coronavirus disease 2019 in Osaka Prefecture, Japan. The proportion of deaths was 8.5% in total and increased with increasing age. Geriatr Gerontol Int 2021; 21: 629-635.

摘要

目的

在日本,尚未充分评估老年患者 2019 年冠状病毒病(COVID-19)的流行病学特征、住院治疗和结局。

方法

本回顾性观察性研究在日本大阪府进行,纳入了 2020 年 1 月至 11 月期间实验室确诊的年龄≥60 岁的 COVID-19 患者。主要结局是根据《传染病控制法》在观察期间的死亡率。采用 Cox 回归分析评估 COVID-19 老年患者的流行病学因素与死亡率之间的关系。

结果

老年患者占 COVID-19 登记患者的 21.5%(3192/14846)。按年龄划分的患者人数如下:60-69 岁 1140 例(35.7%);70-79 岁 1058 例(33.1%);80-89 岁 749 例(23.5%);≥90 岁 245 例(7.7%)。观察期间的死亡率为 8.5%(271/3192)。死亡率随年龄组的增加而升高(从 1.9%升至 20.4%,趋势 P<0.001)。在多变量 Cox 回归分析中,70-79 岁、80-89 岁和≥90 岁的患者死亡的风险比和 95%置信区间均高于 60-69 岁的患者(分别为 2.62[1.63-4.23]、5.99[3.77-9.50]和 10.24[6.03-17.40])。男性、合并症、医疗机构聚集性病例和诊断时为中度/重度症状等因素也与死亡率相关。

结论

本研究显示了日本大阪府老年 COVID-19 患者的流行病学特征。总死亡率为 8.5%,且随年龄增长而升高。老年医学与老年健康学 2021;21:629-635。

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