Andrew Melissa K, Godin Judith, LeBlanc Jason, Boivin Guy, Valiquette Louis, McGeer Allison, McElhaney Janet E, Hatchette Todd F, ElSherif May, MacKinnon-Cameron Donna, Wilson Kevin, Ambrose Ardith, Trottier Sylvie, Loeb Mark, Smith Stephanie W, Katz Kevin, McCarthy Anne, McNeil Shelly A
Geriatric Medicine Research, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Canadian Center for Vaccinology, Halifax, NS, Canada.
Can Geriatr J. 2022 Jun 1;25(2):183-196. doi: 10.5770/cgj.25.546. eCollection 2022 Jun.
We report characteristics and outcomes of adults admitted to Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network hospitals with COVID-19 in 2020.
Patients with laboratory-confirmed COVID-19 admitted to 11 sites in Ontario, Quebec, Alberta, and Nova Scotia up to December 31, 2020 were enrolled in this prospective observational cohort study. Measures included age, sex, demographics, housing, exposures, Clinical Frailty Scale, comorbidities; in addition, length of stay, intensive care unit (ICU) admission, mechanical ventilation, and survival were assessed. Descriptive analyses and multivariable logistic regressions were conducted.
Among 2,011 patients, mean age was 71.0 (range 19-105) years. 29.7% were admitted from assisted living or long-term care facilities. The full spectrum of frailty was represented in both younger and older age groups. 81.8% had at least one underlying comorbidity and 27.2% had obesity. Mortality was 14.3% without ICU admission, and 24.6% for those admitted to ICU. Older age and frailty were independent predictors of lower ICU use and higher mortality; accounting for frailty, obesity was not an independent predictor of mortality, and associations of comorbidities with mortality were weakened.
Frailty is a critical clinical factor in predicting outcomes of COVID-19, which should be considered in research and clinical settings.
我们报告了2020年入住加拿大免疫研究网络（CIRN）严重后果监测（SOS）网络医院的成年新冠肺炎患者的特征和结局。
这项前瞻性观察性队列研究纳入了截至2020年12月31日在安大略省、魁北克省、艾伯塔省和新斯科舍省11个地点收治的实验室确诊的新冠肺炎患者。测量指标包括年龄、性别、人口统计学特征、住房情况、暴露史、临床衰弱量表、合并症；此外，还评估了住院时间、重症监护病房（ICU）入住情况、机械通气情况和生存率。进行了描述性分析和多变量逻辑回归分析。
在2011名患者中，平均年龄为71.0岁（范围19 - 105岁）。29.7%的患者来自辅助生活设施或长期护理机构。各个年龄段的患者均有不同程度的衰弱。81.8%的患者至少有一种基础合并症，27.2%的患者患有肥胖症。未入住ICU的患者死亡率为14.3%，入住ICU的患者死亡率为24.6%。年龄较大和衰弱是ICU使用率较低和死亡率较高的独立预测因素；考虑到衰弱因素，肥胖不是死亡率的独立预测因素，合并症与死亡率之间的关联也有所减弱。
衰弱是预测新冠肺炎结局的关键临床因素，在研究和临床环境中均应予以考虑。
