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2019冠状病毒病大流行背景下的衰弱:一种危及生命的状况。

Frailty in the context of COVID-19 pandemic: A life-threatening condition.

作者信息

Fernandes Alan L, Pereira Rosa M R

机构信息

Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

Front Med (Lausanne). 2022 Aug 24;9:965562. doi: 10.3389/fmed.2022.965562. eCollection 2022.

Abstract

The pandemic outbreak of coronavirus disease 2019 (COVID-19) has caused emerging challenges for healthcare systems regarding the assistance to the older adult population which, added to the increased life expectancy, may be exposing frail older adults to an increased risk of unfavorable health outcomes. Frailty has a pathogenesis of multifactorial etiology and is defined as a condition characterized by progressive decline in physiological function, weakness, decreased strength, and reduced resilience to stressors, leading to vulnerability and an increased risk of fractures, falls, institutionalization, and death. In the context of COVID-19, frail older adults accounted for approximately 51% of hospitalized patients with confirmed cases and elevated risk of mortality in-hospital. In addition, frailty may be associated with recent "excess mortality" reported by the World Health Organization (WHO) in terms of the full death toll associated directly (due to the disease) or indirectly (due to the pandemic's impact on health systems and society) to COVID-19. Therefore, this mini review aimed to provide a summarized discussion from meta-analyses data regarding the impact of frailty in community-dwelling older adults hospitalized with COVID-19 on short-term mortality risk.

摘要

2019年冠状病毒病(COVID-19)的大流行给医疗系统在为老年人群体提供援助方面带来了新挑战,再加上预期寿命的增加,可能会使体弱的老年人面临更不利健康结果的风险增加。衰弱具有多因素病因的发病机制,被定义为一种以生理功能逐渐下降、虚弱、力量减弱以及对应激源的恢复力降低为特征的状态,导致易损性增加以及骨折、跌倒、入住养老院和死亡风险增加。在COVID-19背景下,体弱的老年人约占确诊病例住院患者的51%,且院内死亡风险升高。此外,就与COVID-19直接(由于该疾病)或间接(由于大流行对卫生系统和社会的影响)相关的全部死亡人数而言,衰弱可能与世界卫生组织(WHO)最近报告的“超额死亡率”有关。因此,本综述旨在根据荟萃分析数据,对衰弱对因COVID-19住院的社区居住老年人短期死亡风险的影响进行总结性讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98a/9451136/a893c2e91289/fmed-09-965562-g0001.jpg

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