Clin Lab. 2022 Aug 1;68(8). doi: 10.7754/Clin.Lab.2021.211054.
Coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Geriatric patients with COVID-19 are more likely to progress to severe disease, and they are at increased risk of hospitalization and mortality. In this study we aimed to investigate the risk factors for predicting mortality in geriatric patients with COVID 19 by reviewing the clinical data of survivors and non-survivors.
This was a retrospective study of 189 geriatric patients with COVID- 19 pneumonia who were hospitalized in pulmonology clinic, in Duzce University, Medical Faculty Hospital between March 2020 and January 2021 in Turkey.
In the study, 60.3% (n = 114) of the patients were male and the median age was 75. 80.4% (n = 152) of the patients were discharged. The presence of cardiovascular disease, chronic renal failure, malignancy, increased number of comorbidities, complaints of anorexia, no fever, decreased oxygen saturation value, increased pulse rate, high values of maximum (max) D-dimer, aspartate aminotransferase, urea, creatinine, troponin, lactate dehydrogenase (LDH), max LDH, ferritin and max ferritin, C-reactive protein (CRP), max CRP, procalcitonin, max procalcitonin, potassium values and low albumin values, complications as bacterial infection, cardiac disease, acute respiratory distress syndrome, liver function tests failure, arrhythmia and shock, the need for corticosteroid and pulse corticosteroid therapy increased the mortality. According to multiple logistic regression model, the de-velopment of cardiac disease, acute respiratory distress syndrome, bacterial infection, the need for pulse steroids, and the max ferritin value increased the risk of mortality by between 1.001 and 28.715 times.
Both clinical and laboratory parameters predicting mortality in geriatric patients with COVID-19 pneumonia should be monitored very carefully. Complications that develop should be evaluated and multidisciplinary and necessary treatments should be initiated without delay.
2019 年冠状病毒病(COVID-19)是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的全球大流行。患有 COVID-19 的老年患者更有可能发展为重症疾病,并且他们住院和死亡的风险增加。在这项研究中,我们旨在通过回顾幸存者和非幸存者的临床数据,研究预测 COVID-19 老年患者死亡的危险因素。
这是一项回顾性研究,纳入了 2020 年 3 月至 2021 年 1 月期间在土耳其 Duzce 大学医学院肺病科住院的 189 名 COVID-19 肺炎老年患者。
研究中,60.3%(n=114)的患者为男性,中位年龄为 75.8。80.4%(n=152)的患者出院。心血管疾病、慢性肾功能衰竭、恶性肿瘤、合并症增多、厌食、无发热、氧饱和度值降低、脉搏率升高、最大(max)D-二聚体、天门冬氨酸氨基转移酶、尿素、肌酐、肌钙蛋白、乳酸脱氢酶(LDH)、max LDH、铁蛋白和 max 铁蛋白、C 反应蛋白(CRP)、max CRP、降钙素原、max 降钙素原、钾值和低白蛋白值升高、细菌感染、心脏病、急性呼吸窘迫综合征、肝功能衰竭、心律失常和休克等并发症、需要皮质类固醇和脉冲皮质类固醇治疗都会增加死亡率。根据多变量逻辑回归模型,心脏病、急性呼吸窘迫综合征、细菌感染、需要脉冲类固醇治疗和 max 铁蛋白值增加的患者,死亡率分别增加 1.001 至 28.715 倍。
应非常仔细地监测预测 COVID-19 肺炎老年患者死亡的临床和实验室参数。应评估所发生的并发症,并应立即开展多学科和必要的治疗。