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年龄与合并症相互作用在新冠病毒疾病死亡中的作用:来自心脏和肺部疾病的见解

The Role of Age and Comorbidity Interactions in COVID-19 Mortality: Insights from Cardiac and Pulmonary Conditions.

作者信息

Patrascu Raul, Dumitru Cristina Stefania, Laza Ruxandra, Besliu Razvan Sebastian, Gug Miruna, Zara Flavia, Laitin Sorina Maria Denisa

机构信息

Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

Department of Microscopic Morphology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

出版信息

J Clin Med. 2024 Dec 10;13(24):7510. doi: 10.3390/jcm13247510.

Abstract

: Understanding the interactions between age and comorbidities is crucial for assessing COVID-19 mortality, particularly in patients with cardiac and pulmonary conditions. This study investigates the relationship between comorbidities and mortality outcomes in a cohort of hospitalized COVID-19 patients, emphasizing the interplay of age, cardiac, and pulmonary conditions. : We analyzed a cohort of 3005 patients hospitalized with COVID-19 between 2020 and 2022. Key variables included age, comorbidities (diabetes, cardiac, pulmonary, and neoplasms), and clinical outcomes. Chi-square tests and logistic regression models were used to assess the association between comorbidities and mortality. Stratified analyses by age, diabetes, and pulmonary conditions were conducted to explore interaction effects. Additionally, interaction terms were included in multivariable logistic regression models to evaluate the combined impact of age, comorbidities, and mortality. : Cardiac conditions such as hypertension, ischemic cardiopathy, and myocardial infarction showed significant protective effects against mortality in younger patients and in those without pulmonary conditions ( < 0.001). However, these protective effects were diminished in older patients and those with pulmonary comorbidities. Age was found to be a significant modifier of the relationship between cardiac conditions and mortality, with a stronger protective effect observed in patients under the median age ( < 0.001). Pulmonary comorbidities significantly increased the risk of mortality, particularly when co-occurring with cardiac conditions ( < 0.001). Diabetes did not significantly modify the relationship between cardiac conditions and mortality. : The findings highlight the complex interactions between age, cardiac conditions, and pulmonary conditions in predicting COVID-19 mortality. Younger patients with cardiac comorbidities show a protective effect against mortality, while pulmonary conditions increase mortality risk, especially in older patients. These insights suggest that individualized risk assessments incorporating age and comorbidities are essential for managing COVID-19 outcomes.

摘要

了解年龄与合并症之间的相互作用对于评估新冠病毒病(COVID-19)死亡率至关重要,尤其是对于患有心脏和肺部疾病的患者。本研究调查了一组住院COVID-19患者中合并症与死亡结局之间的关系,重点关注年龄、心脏和肺部疾病之间的相互作用。:我们分析了2020年至2022年间因COVID-19住院的3005例患者队列。关键变量包括年龄、合并症(糖尿病、心脏疾病、肺部疾病和肿瘤)以及临床结局。采用卡方检验和逻辑回归模型评估合并症与死亡率之间的关联。按年龄、糖尿病和肺部疾病进行分层分析以探讨交互作用。此外,在多变量逻辑回归模型中纳入交互项以评估年龄、合并症和死亡率的综合影响。:高血压、缺血性心脏病和心肌梗死等心脏疾病对年轻患者以及无肺部疾病的患者的死亡率显示出显著的保护作用(<0.001)。然而,在老年患者和患有肺部合并症的患者中,这些保护作用减弱。年龄被发现是心脏疾病与死亡率之间关系的显著调节因素,在年龄中位数以下的患者中观察到更强的保护作用(<0.001)。肺部合并症显著增加了死亡风险,尤其是与心脏疾病同时存在时(<0.001)。糖尿病并未显著改变心脏疾病与死亡率之间的关系。:研究结果突出了年龄、心脏疾病和肺部疾病在预测COVID-19死亡率方面的复杂相互作用。患有心脏合并症的年轻患者对死亡率有保护作用,而肺部疾病会增加死亡风险,尤其是在老年患者中。这些见解表明,纳入年龄和合并症的个体化风险评估对于管理COVID-19结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e65c/11677844/4ad3bad068a8/jcm-13-07510-g001.jpg

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