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老年人 COVID-19 症状持续存在的流行率和预测因素:一项单中心研究。

Prevalence and Predictors of Persistence of COVID-19 Symptoms in Older Adults: A Single-Center Study.

机构信息

Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.

Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.

出版信息

J Am Med Dir Assoc. 2021 Sep;22(9):1840-1844. doi: 10.1016/j.jamda.2021.07.003. Epub 2021 Jul 19.

Abstract

OBJECTIVES

Symptom persistence weeks after laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance is a relatively common long-term complication of Coronavirus disease 2019 (COVID-19). Little is known about this phenomenon in older adults. The present study aimed at determining the prevalence of persistent symptoms among older COVID-19 survivors and identifying symptom patterns.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

We analyzed data collected in people 65 years and older (n = 165) who were hospitalized for COVID-19 and then admitted to the Day Hospital Post-COVID 19 of the Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS (Rome, Italy) between April and December 2020. All patients tested negative for SARS-CoV-2 and met the World Health Organization criteria for quarantine discontinuation.

MEASURES

Patients were offered multidisciplinary individualized assessments. The persistence of symptoms was evaluated on admission using a standardized questionnaire.

RESULTS

The mean age was 73.1 ± 6.2 years (median 72, interquartile range 27), and 63 (38.4%) were women. The average time elapsed from hospital discharge was 76.8 ± 20.3 days (range 25-109 days). On admission, 137 (83%) patients reported at least 1 persistent symptom. Of these, more than one-third reported 1 or 2 symptoms and 46.3% had 3 or more symptoms. The rate of symptom persistence was not significantly different when patients were stratified according to median age. Compared with those with no persistent symptoms, patients with symptom persistence reported a greater number of symptoms during acute COVID-19 (5.3 ± 3.0 vs 3.3 ± 2.0; P < .001). The most common persistent symptoms were fatigue (53.1%), dyspnea (51.5%), joint pain (22.2%), and cough (16.7%). The likelihood of symptom persistence was higher in those who had experienced fatigue during acute COVID-19.

CONCLUSIONS AND IMPLICATIONS

Persistent symptoms are frequently experienced by older adults who have been hospitalized for COVID-19. Follow-up programs should be implemented to monitor and care for long-term COVID-19-related health issues.

摘要

目的

实验室确认的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)清除后数周持续存在症状是 2019 年冠状病毒病(COVID-19)的一种相对常见的长期并发症。老年人中对此现象知之甚少。本研究旨在确定 COVID-19 幸存者中持续存在症状的患病率,并确定症状模式。

设计

横断面研究。

地点和参与者

我们分析了 2020 年 4 月至 12 月期间在意大利罗马的 Fondazione Policlinico Universitario“Agostino Gemelli”IRCCS 日医院后 COVID-19 病房住院治疗 COVID-19 并随后住院的 165 名 65 岁及以上(n=165)患者的数据。所有患者 SARS-CoV-2 检测均为阴性,并符合世界卫生组织隔离终止标准。

措施

为患者提供了多学科的个性化评估。使用标准化问卷在入院时评估症状的持续存在。

结果

平均年龄为 73.1±6.2 岁(中位数 72,四分位距 27),63 人(38.4%)为女性。从出院到入院的平均时间为 76.8±20.3 天(范围 25-109 天)。入院时,137 名(83%)患者报告至少存在 1 种持续症状。其中,超过三分之一的患者报告了 1 或 2 种症状,46.3%的患者有 3 种或更多症状。根据中位年龄对患者进行分层时,症状持续存在的发生率没有显著差异。与无症状持续存在的患者相比,症状持续存在的患者在急性 COVID-19 期间报告的症状更多(5.3±3.0 与 3.3±2.0;P<0.001)。最常见的持续症状是疲劳(53.1%)、呼吸困难(51.5%)、关节痛(22.2%)和咳嗽(16.7%)。在急性 COVID-19 期间经历过疲劳的患者,症状持续存在的可能性更高。

结论和意义

曾因 COVID-19 住院的老年人经常出现持续症状。应实施随访计划,以监测和护理与 COVID-19 相关的长期健康问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1b4/8286874/c114743e30ae/gr1_lrg.jpg

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