Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong.
Hong Kong Med J. 2022 Jun;28(3):215-222. doi: 10.12809/hkmj219367. Epub 2022 Jun 10.
Compared with previous waves of the coronavirus disease 2019 (COVID-19) pandemic in Hong Kong, the third wave involved a greater number of frail older patients. Because local healthcare policy required hospitalisation for all older adults with COVID-19, we aimed to investigate the clinical course and outcomes in such patients.
This retrospective observational study included all patients aged ≥65 years who were admitted to Tuen Mun Hospital for management of COVID-19 between 1 July 2020 and 31 August 2020. We reviewed baseline characteristics, clinical presentation, laboratory results, complications, and outcomes. We also investigated the associations of age and Clinical Frailty Scale (CFS) score with in-patient mortality.
In total, 101 patients were included (median age, 73 years); 52.5% were men and 85% had at least co-morbid chronic disease. The most common symptoms were fever (80.2%) and cough (63.4%). Fifty-two patients (51.5%) developed hypoxia, generally on day 8 (interquartile range, 5-11) after symptom onset. Of the 16 patients who required intensive care unit support, 13 required mechanical ventilation. The overall mortality rate was 16.8%. Patients aged 65-69, 70-79, 80-89, and ≥90 years had mortality rates of 9.1%, 10%, 30%, and 25%, respectively. Patients with CFS scores of 1-2, 3-4, 5-6, and ≥7 had mortality rates of 5.7%, 14.7%, 23.5%, and 40%, respectively. A linear relationship was confirmed between the two mortality trends.
Clinical deterioration was common in older patients with COVID-19; their overall mortality rate was 16.8%. Mortality increased linearly with both age and CFS score.
与香港之前几波 2019 年冠状病毒病（COVID-19）疫情相比，第三波疫情涉及到更多体弱的老年患者。由于当地医疗政策要求所有 COVID-19 老年患者住院治疗，我们旨在调查此类患者的临床过程和结局。
这项回顾性观察性研究纳入了 2020 年 7 月 1 日至 2020 年 8 月 31 日期间因 COVID-19 入住屯门医院的所有 65 岁及以上患者。我们回顾了基线特征、临床表现、实验室结果、并发症和结局。我们还研究了年龄和临床虚弱量表（CFS）评分与住院死亡率的关系。
共纳入 101 例患者（中位年龄 73 岁）；52.5%为男性，85%至少患有合并慢性疾病。最常见的症状是发热（80.2%）和咳嗽（63.4%）。52 例患者（51.5%）出现低氧血症，一般在症状出现后第 8 天（四分位距 5-11）。需要重症监护病房支持的 16 例患者中，有 13 例需要机械通气。总体死亡率为 16.8%。年龄为 65-69 岁、70-79 岁、80-89 岁和≥90 岁的患者死亡率分别为 9.1%、10%、30%和 25%。CFS 评分为 1-2、3-4、5-6 和≥7 的患者死亡率分别为 5.7%、14.7%、23.5%和 40%。两种死亡率趋势之间存在线性关系。
COVID-19 老年患者病情恶化常见，总体死亡率为 16.8%。死亡率与年龄和 CFS 评分均呈线性关系增加。
