Bakhshwin Duaa, Alotaibi Musim, Ali Ahmed S, Althomali Abdullah, Alsuwat Abdullah, Alhamyani Abdulrahman, Alwathnani Abdulqader, Alsaggaf Samar, Alrafiah Aziza
Department of Pharmacology Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
King Faisal Medical Complex, Taif, Kingdom of Saudi Arabia.
Infect Drug Resist. 2022 Jun 20;15:3213-3223. doi: 10.2147/IDR.S364279. eCollection 2022.
By December 2021, the COVID-19 pandemic had caused more than 266 million cases and 5 million deaths, especially among geriatric patients.
To identify determinants of COVID-19-related death in geriatric patients.
This is a comparative retrospective study involving 145 COVID-19 hospitalized patients who are more than 60 years old, conducted at King Faisal Medical Complex in Taif, Saudi Arabia, from June 2020 to August 2020. The main outcome studied was COVID-19-related death.
Out of 145 elderly COVID-19 patients, 11% have died. There was a significant difference between those who died and the surviving group regarding hospital stay duration, with a higher duration median among those who died (22 days vs 12 day respectively, p=0.002). Transfer to ICU, mechanical ventilation, low oxygen saturation, shortness of breath, respiratory support, x-ray trend, and prolonged QT interval showed significant statistical differences between them (p<0.001, <0.001, 0.017, 0.045, <0.001, <0.001, 0.004, respectively). After doing logistic regression of predictors for progression to death, putting patients on oxygen only vs mechanical ventilation was statistically significant, with an adjusted odds ratio (AOR) of 0.038 (p=0.012). Worse x-rays vs constant also were statistically significant and had AOR of 23.459 (p=0.001). There was a significant moderate positive correlation between duration of hospital stay and duration from admission to medication start (SP=0.336 and p<0.001).
We recommend accurately monitoring patients using x-rays to determine which patients have worse x-rays. However, the cost-benefit of using radiation must be well assessed and needs further research to determine if its benefit outweighs its risks, especially in high-risk patients. Furthermore, mechanically ventilated patients must be carefully monitored. Finally, the duration of hospital stay was highly correlated with the duration from admission to medication start. Therefore, proper treatment must be started as early as possible.
截至2021年12月，新冠疫情已导致超过2.66亿例感染和500万人死亡，老年患者尤为严重。
确定老年患者中与新冠相关死亡的决定因素。
这是一项比较性回顾研究，于2020年6月至2020年8月在沙特阿拉伯塔伊夫的费萨尔国王医疗中心对145名60岁以上的新冠住院患者进行。研究的主要结局是与新冠相关的死亡。
145名老年新冠患者中，11%死亡。死亡患者与存活组在住院时间上存在显著差异，死亡患者的住院时间中位数更高（分别为22天和12天，p = 0.002）。转入重症监护病房、机械通气、低氧饱和度、呼吸急促、呼吸支持、X线变化趋势和QT间期延长在两组间显示出显著的统计学差异（p分别<0.001、<0.001、0.017、0.045、<0.001、<0.001、0.004）。对死亡进展的预测因素进行逻辑回归分析后，仅给予患者吸氧与机械通气相比具有统计学意义，调整后的优势比（AOR）为0.038（p = 0.012）。X线表现较差与稳定相比也具有统计学意义，AOR为23.459（p = 0.001）。住院时间与从入院到开始用药的时间之间存在显著的中度正相关（SP = 0.336，p < 0.001）。
我们建议使用X线准确监测患者，以确定哪些患者的X线表现较差。然而，使用辐射的成本效益必须得到充分评估，需要进一步研究以确定其益处是否大于风险，尤其是在高危患者中。此外，必须对接受机械通气的患者进行仔细监测。最后，住院时间与从入院到开始用药的时间高度相关。因此，必须尽早开始适当治疗。
