School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
Department of Geriatrics, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
Clin Interv Aging. 2023 Nov 20;18:1905-1921. doi: 10.2147/CIA.S431271. eCollection 2023.
Corona Virus Disease 2019 (COVID-19) endangers the health and survival of the elderly. We tried to explore factors especially kidney function which affected mortality in elderly hypertensive patients with COVID-19.
We conducted a retrospective research of 748 COVID-19 elderly patients (≥65 years old) at Zhejiang Hospital. This study compared demographic data, laboratory values, comorbidities, treatments, and clinical outcomes of hypertension and non-hypertension participants, and subgroup analysis of age and frailty was conducted in the hypertension population. Survival analysis was used to determine risk factors for death in elderly patients with COVID-19.
Our study revealed that the elderly hypertensive patients with COVID-19 had higher blood urea nitrogen (BUN), serum uric acid (UA), serum creatinine (Scr), lower estimated glomerular filtration rate (eGFR), higher incidence of severity, admission to intensive care unit (ICU) and death, and longer in-hospital stay than non-hypertensive patients, which also occurred in the very elderly hypertensive patients compared with younger hypertensive patients and frail hypertensive patients compared with no-frail hypertensive patients. In addition, the prevalence of acute kidney injury (AKI) was higher in the oldest old hypertensive patients and frail hypertensive patients. Multivariate survival analysis indicated that the independent risk factors for death from COVID-19 were age ≥80 years, heart failure, antiviral therapy, calcium channel blocker (CCB) therapy, mechanical ventilation, AKI, and eGFR<60 mL/min per 1.73 m.
The results of the present study suggested that the elderly hypertensive patients with COVID-19 would have more serious kidney injury, more serious disease progression and higher mortality, which also occurred in very elderly and frailty subgroup. Kidney dysfunction was closely related to mortality in elderly patients with COVID-19.
2019 年冠状病毒病（COVID-19）危害老年人的健康和生存。我们试图探讨影响 COVID-19 老年高血压患者死亡率的因素，特别是肾功能。
我们对浙江医院 748 例 COVID-19 老年患者（≥65 岁）进行了回顾性研究。本研究比较了高血压和非高血压患者的人口统计学数据、实验室值、合并症、治疗和临床结局，并对高血压患者进行了年龄和脆弱亚组分析。生存分析用于确定 COVID-19 老年患者死亡的危险因素。
我们的研究表明，COVID-19 的老年高血压患者的血尿素氮（BUN）、血尿酸（UA）、血清肌酐（Scr）较高，估算肾小球滤过率（eGFR）较低，严重程度、入住重症监护病房（ICU）和死亡率较高，住院时间较长，与非高血压患者相比，高龄高血压患者与年轻高血压患者相比，脆弱高血压患者与非脆弱高血压患者相比，情况更为严重。此外，在年龄最大的高血压患者和脆弱高血压患者中，急性肾损伤（AKI）的患病率更高。多变量生存分析表明，COVID-19 死亡的独立危险因素是年龄≥80 岁、心力衰竭、抗病毒治疗、钙通道阻滞剂（CCB）治疗、机械通气、AKI 和 eGFR<60 mL/min/1.73 m。
本研究结果表明，COVID-19 的老年高血压患者的肾脏损伤更严重，疾病进展更严重，死亡率更高，这在高龄和脆弱亚组中也更为明显。肾功能障碍与 COVID-19 老年患者的死亡率密切相关。
