骨质疏松性肌少症及其参数对COVID-19住院老年患者死亡率的影响：BEH（布什尔老年人健康）项目的研究结果
The impact of osteosarcopenia and its parameters on mortality of COVID-19 in-hospitalized older patients: the findings of BEH (Bushehr elderly health) program.
作者信息
Shafiee Gita, Marzban Maryam, Abbaspour Faeze, Darabi Amirhossein, Balajam Narges Zargar, Farhadi Akram, Khaleghi Mohammad Mehdi, Taherzadeh Hossein, Fahimfar Noushin, Falahatzadeh Azar, Ghasemi Negin, Ostovar Afshin, Nabipour Iraj, Larijani Bagher, Heshmat Ramin
机构信息
Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia.
出版信息
J Diabetes Metab Disord. 2024 Jun 12;23(2):1919-1928. doi: 10.1007/s40200-024-01443-1. eCollection 2024 Dec.
BACKGROUND
It has been documented that old age and chronic diseases are associated with poor prognosis and mortality among COVID-19 patients. Osteosarcopenia is a geriatric syndrome with a considerable prevalence which increases morbidity and mortality. This study investigated the relationship between COVID-19 mortality and osteosarcopenia and its parameters in-hospitalized patients in Bushehr, Iran.
METHODS
In this retrospective cohort study, participants of the Bushehr Elderly Health (BEH) program who were hospitalized due to COVID-19 between 1st March 2020 and 23rd September 2021 were assessed. Osteosarcopenia was considered as the presence of both osteopenia/osteoporosis and sarcopenia. We used the Cox proportional hazards model to identify the association between oteosarcopenia and the risk of COVID-mortality in 2442 person-days.
RESULTS
Among 4173 participants,297 patients were in-hospitalized due to COVID-19. We found that 80(26.94%) patients expired due to COVID-19 during the follow-up period. Osteosarcopenia and its parameters were more prevalent in patients who expired. The incidence rate of mortality among osteosarcopenic patients was 5.04(3.43- 7.40) per 100 person-days. In the Cox proportional hazards models, osteosarcopenia and its parameters increase the risk of COVID-mortality [Osteosarcopenia: HR:1.73(1.00-3.01), sarcopenia: HR:1.72(1.00-2.99), Osteoporosis: HR:2.67(1.53-4.67), Low muscle mass: HR:1.90(1.05-3.46), low muscle strength: HR:1.80(1.03-3.16), and low gait speed: HRadj:2.39(1.31-4.38). The ORs of ICU admission and use of invasive mechanical ventilation among osteosarcopenic patients and its parameters were higher than those without it.
CONCLUSIONS
This study identified the impact of osteosarcopenia and its parameters on the mortality of in-hospitalized patients with COVID-19. Assessment of musculoskeletal disorders could help in early warning of older patients with severe COVID-19.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-024-01443-1.
背景
已有文献记载，高龄和慢性病与新冠病毒病（COVID-19）患者的不良预后及死亡率相关。骨质疏松性肌少症是一种患病率颇高的老年综合征，会增加发病率和死亡率。本研究调查了伊朗布什尔住院患者中COVID-19死亡率与骨质疏松性肌少症及其各项参数之间的关系。
方法
在这项回顾性队列研究中，对参加布什尔老年健康（BEH）计划且于2020年3月1日至2021年9月23日期间因COVID-19住院的参与者进行了评估。骨质疏松性肌少症被定义为同时存在骨质减少/骨质疏松和肌少症。我们使用Cox比例风险模型，在2442人日中确定骨质疏松性肌少症与COVID-19死亡风险之间的关联。
结果
在4173名参与者中，297名患者因COVID-19住院。我们发现，80名（26.94%）患者在随访期间因COVID-19死亡。骨质疏松性肌少症及其各项参数在死亡患者中更为普遍。骨质疏松性肌少症患者的死亡率为每100人日5.04（3.43 - 7.40）。在Cox比例风险模型中，骨质疏松性肌少症及其各项参数会增加COVID-19死亡风险[骨质疏松性肌少症：风险比（HR）：1.73（1.00 - 3.01），肌少症：HR：1.72（1.00 - 2.99），骨质疏松：HR：2.67（1.53 - 4.67），低肌肉量：HR：1.90（1.05 - 3.46），低肌肉力量：HR：1.80（1.03 - 3.16），低步速：校正后HR：2.39（1.31 - 4.38）]。骨质疏松性肌少症患者及其各项参数入住重症监护病房（ICU）和使用有创机械通气的比值比高于未患该症的患者。
结论
本研究确定了骨质疏松性肌少症及其各项参数对COVID-19住院患者死亡率的影响。评估肌肉骨骼疾病有助于对重症COVID-19老年患者进行早期预警。
补充信息
网络版包含可在10.1007/s40200-024-01443-1获取的补充材料。
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