Department of Infectious Disease, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
Emerg Microbes Infect. 2022 Dec;11(1):2045-2054. doi: 10.1080/22221751.2022.2109517.
Shanghai has been experiencing the Omicron wave since March 2022. Though several studies have evaluated the risk factors of severe infections, the analyses of BA.2 infection risk and protective factors among geriatric people were much limited. This multicentre cohort study described clinical characteristics, and assessed risk and protective factors for geriatric Omicron severe infections. A total of 1377 patients older than 60 were enrolled, with 75.96% having comorbidities. The median viral shedding time and hospitalization time were nine and eight days, respectively. Severe and critical were associated with longer virus clearance time (aOR [95%CI]:0.706 (0.533-0.935), = .015), while fully vaccinated/booster and paxlovid use shortened viral shedding time (1.229 [1.076-1.402], = .002; 1.140 [0.019-1.274], = .022, respectively). Older age (>80), cerebrovascular disease, and chronic kidney disease were risk factors of severe/critical. Fully vaccination was a significant protective factor against severe infections (0.237 [0.071-0.793], = .019). We found patients with more than two comorbidities were more likely to get serious outcomes. These findings demonstrated that in the elderly older than 60 years old, older age (aged over 80), cerebrovascular disease, and chronic kidney disease were risk factors for severe infection. Patients with more than two comorbidities were more likely to get serious outcomes. Fully vaccinated/booster patients were less likely to be severe and vaccinations could shorten viral shedding time. The limitation of lacking an overall spectrum of COVID-19 infections among elders could be compensated in other larger-scale studies in the future.
上海自 2022 年 3 月以来一直经历着奥密克戎波。尽管有几项研究评估了严重感染的危险因素，但对老年人 BA.2 感染风险和保护因素的分析却非常有限。本多中心队列研究描述了临床特征，并评估了老年奥密克戎重症感染的风险和保护因素。共纳入 1377 名年龄大于 60 岁的患者，其中 75.96%有合并症。中位病毒脱落时间和住院时间分别为 9 天和 8 天。严重和危重症与病毒清除时间延长相关（aOR [95%CI]：0.706 [0.533-0.935]，=0.015），而完全接种/加强接种和使用帕罗韦德缩短了病毒脱落时间（1.229 [1.076-1.402]，=0.002；1.140 [0.019-1.274]，=0.022）。年龄较大（>80 岁）、脑血管疾病和慢性肾脏病是严重/危重症的危险因素。完全接种是严重感染的显著保护因素（0.237 [0.071-0.793]，=0.019）。我们发现合并症超过两种的患者更有可能出现严重结局。这些发现表明，在 60 岁以上的老年人中，年龄较大（>80 岁）、脑血管疾病和慢性肾脏病是严重感染的危险因素。合并症超过两种的患者更有可能出现严重结局。完全接种/加强接种的患者不太可能出现严重感染，且接种疫苗可以缩短病毒脱落时间。未来在其他更大规模的研究中，可以弥补缺乏老年人 COVID-19 感染全貌的局限性。
