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新型冠状病毒肺炎与虚弱

COVID-19 and Frailty.

作者信息

Ciarambino Tiziana, Crispino Pietro, Minervini Giovanni, Giordano Mauro

机构信息

Internal Medicine Department, Hospital of Marcianise, ASL Caserta, 81037 Caserta, Italy.

Internal Medicine Department, Hospital of Latina, ASL Latina, 04100 Latina, Italy.

出版信息

Vaccines (Basel). 2023 Mar 7;11(3):606. doi: 10.3390/vaccines11030606.

DOI:10.3390/vaccines11030606
PMID:36992190
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10057998/
Abstract

Older age is a major risk factor for adverse outcomes of COVID-19, potentially due to immunosenescence and chronic low-grade inflammation, both characteristics of older adults which synergistically contribute to their vulnerability. Furthermore, older age is also associated with decreased kidney function and is consequently associated with an increased risk of cardiovascular disease. All of this in the course of COVID-19 infection can worsen and promote the progression of chronic kidney damage and all its sequelae. Frailty is a condition characterized by the decline in function of several homeostatic systems, leading to increased vulnerability to stressors and risk of adverse health outcomes. Thus, it is very likely that frailty, together with comorbidities, may have contributed to the high vulnerability to severe clinical manifestations and deaths from COVID-19 among older people. The combination of viral infection and chronic inflammation in the elderly could cause multiple unforeseen harmful consequences, affecting overall disability and mortality rates. In post-COVID-19 patients, inflammation has been implicated in sarcopenia progression, functional activity decline, and dementia. After the pandemic, it is imperative to shine a spotlight on these sequelae so that we can be prepared for the future outcomes of the ongoing pandemic. Here, we discuss the potential long-term consequences of SARS-CoV-2 infection and its possibility of causing permanent damage to the precarious balance existing in the frail elderly with multiple pathologies.

摘要

高龄是新冠病毒病不良结局的主要风险因素,这可能归因于免疫衰老和慢性低度炎症,而这两者都是老年人的特征,它们共同导致了老年人的脆弱性。此外,高龄还与肾功能下降有关,因此与心血管疾病风险增加相关。在新冠病毒感染过程中,所有这些情况都可能恶化,并促进慢性肾脏损伤及其所有后遗症的进展。衰弱是一种以多个内稳态系统功能下降为特征的状态,导致对压力源的易感性增加和不良健康结局风险升高。因此,衰弱与合并症很可能是导致老年人对新冠病毒病严重临床表现和死亡高度脆弱的原因。老年人病毒感染与慢性炎症的结合可能会导致多种不可预见的有害后果,影响总体残疾率和死亡率。在新冠病毒病康复患者中,炎症与肌肉减少症进展、功能活动下降和痴呆症有关。疫情过后,必须关注这些后遗症,以便我们能够为当前疫情的未来后果做好准备。在此,我们讨论了严重急性呼吸综合征冠状病毒2感染的潜在长期后果,以及它对患有多种疾病的体弱老年人中现有脆弱平衡造成永久性损害的可能性。