Georgakopoulou Vasiliki Epameinondas, Gkoufa Aikaterini, Bougea Anastasia, Basoulis Dimitrios, Tsakanikas Aristeidis, Makrodimitri Sotiria, Karamanakos Georgios, Spandidos Demetrios A, Angelopoulou Efthalia, Sipsas Nikolaos V
Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Med Int (Lond). 2023 Jul 4;3(4):34. doi: 10.3892/mi.2023.94. eCollection 2023 Jul-Aug.
Patients with Parkinson's disease (PD) and coronavirus disease 2019 (COVID-19)-associated pneumonia present, according to the literature, high mortality rates due to the nature of the disease, advanced age, and underlying diseases. Most available studies, however, refer to the first waves of the pandemic. The aim of the present study was to investigate the clinical characteristics and outcomes of elderly patients (≥65 years old) with PD hospitalized with COVID-19-associated pneumonia during the period of prevalence of various severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, as well as to determine possible prognostic factors for poor outcomes. During the period from February 15, 2021, to July 15, 2022, 1,144 elderly patients with COVID-19 pneumonia were hospitalized. Age, sex, Charlson comorbidity index, vaccination status against SARS-CoV-2, and admission laboratory parameters were recorded for all patients. A total of 36 (3.1%) patients with PD were hospitalized due to COVID-19-associated pneumonia (18 males, 50%). The mean age of the patients was 82.72±8.18 years. In total, 8 patients (22.2%) were hospitalized during the period of alpha variant predominance, 3 patients (8.3%) during the period of delta variant predominance, and 25 patients (69.4%) during the omicron variant predominance period. Of note, 16 patients (44.4%) were vaccinated with at least two doses. In addition, 17 (47.2%) patients succumbed to the disease. Between the patients who survived and those who succumbed, a statistically significant difference was only found in the mean value of albumin (37.48±6.02 vs. 31.97±5.34 g/l, P=0.019). In particular, as shown by receiver operating characteristic curve analysis, albumin exhibited a satisfactory predictive ability for mortality (area under the curve, 0.780; P=0.013) with an albumin value ≤37.7 g/l being able to predict mortality with 85.7% sensitivity and 54.8% specificity. Overall, the findings of the present study indicate that mortality among elderly patients with PD hospitalized with COVID-19-associated pneumonia was high in all phases of the pandemic. A low albumin value, not only as an indicator of the immune status, but also of the nutritional status, is a predictor of adverse outcomes.
根据文献，帕金森病（PD）患者以及2019冠状病毒病（COVID-19）相关肺炎患者由于疾病性质、高龄和基础疾病，死亡率较高。然而，大多数现有研究涉及的是疫情的第一波。本研究的目的是调查在各种严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变异株流行期间，因COVID-19相关肺炎住院的老年患者（≥65岁）的临床特征和结局，并确定可能导致不良结局的预后因素。在2021年2月15日至2022年7月15日期间，1144例老年COVID-19肺炎患者住院。记录了所有患者的年龄、性别、查尔森合并症指数、SARS-CoV-2疫苗接种状况以及入院实验室参数。共有36例（3.1%）PD患者因COVID-19相关肺炎住院（18例男性，占50%）。患者的平均年龄为82.72±8.18岁。总共有8例患者（22.2%）在α变异株占主导期间住院，3例患者（8.3%）在δ变异株占主导期间住院，25例患者（69.4%）在奥密克戎变异株占主导期间住院。值得注意的是，16例患者（44.4%）接种了至少两剂疫苗。此外，17例（47.2%）患者死于该疾病。在存活患者和死亡患者之间，仅在白蛋白平均值方面发现有统计学显著差异（37.48±6.02 vs. 31.97±5.34 g/l，P = 0.019）。特别是，通过受试者工作特征曲线分析表明，白蛋白对死亡率具有令人满意的预测能力（曲线下面积，0.780；P = 0.013），白蛋白值≤37.7 g/l能够以85.7%的敏感性和54.8%的特异性预测死亡率。总体而言，本研究结果表明，在疫情的各个阶段，因COVID-19相关肺炎住院的老年PD患者死亡率都很高。低白蛋白值不仅是免疫状态的指标，也是营养状态的指标，是不良结局的预测因素。
