Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.
University Côte d'Azur, Nice, France.
PLoS One. 2023 Jul 27;18(7):e0289297. doi: 10.1371/journal.pone.0289297. eCollection 2023.
SARS-CoV2 infection has affected many older people and has required us to adapt our practices to this new pathology. Initial functional capacity is already considered an important prognostic marker in older patients particularly during infections.
The objective of this longitudinal study was to determine whether baseline functional disability was associated with mortality risk after 1 year in older patients hospitalized for COVID-19.
All COVID-19 patients admitted to the geriatric acute care unit of Angers University Hospital, France, between March-June 2020 received a group iso-ressource (GIR) assessment upon admission. Disability was defined as a GIR score≤3. All-cause mortality was collected after 1 year of follow-up. Covariables were age, sex, history of malignancies, hypertension, cardiomyopathy, number of acute diseases at baseline, and use of antibiotics or respiratory treatments during COVID-19 acute phase.
In total, 97 participants (mean±SD 88.0+5.4 years; 49.5% women; 46.4% GIR score≤3) were included. 24 of the 36 patients who did not survive 1 year had a GIR score ≤ 3 (66.7%; P = 0.003). GIR score≤3 was directly associated with 1-year mortality (fully adjusted HR = 2.27 95% CI: 1.07-4.89). Those with GIR≤3 at baseline had shorter survival time than the others (log-rank P = 0.0029).
Initial functional disability was associated with poorer survival in hospitalized frail elderly COVID-19 patients.
ClinicalTrials.gov: NCT04560608 registered on September 23, 2022.
SARS-CoV2 感染影响了许多老年人，我们需要根据这种新的病理情况调整我们的治疗方法。在老年人中，初始功能能力已经被认为是一个重要的预后标志物，特别是在感染期间。
本纵向研究的目的是确定 COVID-19 住院老年患者的基线功能障碍是否与 1 年后的死亡率相关。
法国昂热大学医院老年急性护理病房于 2020 年 3 月至 6 月期间收治的所有 COVID-19 患者在入院时均接受了一组等资源（GIR）评估。残疾定义为 GIR 评分≤3。在 1 年的随访后收集全因死亡率。协变量为年龄、性别、恶性肿瘤史、高血压、心肌病、基线时急性疾病的数量以及 COVID-19 急性期抗生素或呼吸治疗的使用情况。
共有 97 名参与者（平均年龄+标准差 88.0+5.4 岁；49.5%女性；46.4%GIR 评分≤3）纳入研究。在未存活 1 年的 36 名患者中，有 24 名（66.7%；P=0.003）的 GIR 评分≤3。GIR 评分≤3 与 1 年死亡率直接相关（完全调整的 HR=2.27 95%CI：1.07-4.89）。与基线时 GIR≤3 的患者相比，其他患者的生存时间更短（对数秩 P=0.0029）。
初始功能障碍与住院虚弱老年 COVID-19 患者的较差生存相关。
ClinicalTrials.gov：NCT04560608 于 2022 年 9 月 23 日注册。
