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[新型冠状病毒肺炎住院老年患者的非典型临床特征及死亡率]

[Atypical clinical and mortality in older adults hospitalized with COVID-19 pneumonia].

作者信息

Valencia-Blancas Tlalnelli, Pérez-Orozco Lucía Herlinda, Durán-Góme Verónica, García-Barboza Evelín, López-Anguiano Roberto Rivelino

机构信息

Instituto Mexicano del Seguro Social, Hospital General Regional No. 2, Servicio de Geriatría. Ciudad de México, México.

Instituto Mexicano del Seguro Social, Hospital General de Zona No. 27, Servicio de Geriatría. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2025 May 2;63(3):e6350. doi: 10.5281/zenodo.15178449.

Abstract

BACKGROUND

Pneumonia caused by SARS-CoV-2 is a public health problem. Older adults are vulnerable and the atypical presentation delays diagnosis and increases mortality. In this group the atypical clinical manifestations are more frequent.

OBJECTIVE

To identify the clinical manifestations and mortality of COVID-19 pneumonia in hospitalized older adults.

MATERIAL AND METHODS

A comparative cross-sectional observational study was carried out, from July 1, 2020, to December 31, 2021, in a general hospital of Mexico City. Patients aged 60 years or more who were hospitalized with a diagnosis of COVID-19 were included.

RESULTS

267 older adults participated; 53.9% were men, with a median age of 74 years. The most frequent comorbidities in this population were type 2 diabetes mellitus (T2DM), hypertension and chronic obstructive pulmonary disease (COPD). 41.2% showed atypical presentation of the disease; mortality in the studied population was 53.5%.

CONCLUSIONS

The atypical presentation of COVID-19 pneumonia is common in adults over 60 years of age and it increases significantly as they become older. The absence of typical symptoms of pneumonia and the ignorance of the most common signs could delay diagnosis and timely care in this age group, which may increase complications and mortality.

摘要

背景

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的肺炎是一个公共卫生问题。老年人易受影响,非典型表现会延迟诊断并增加死亡率。在这一群体中,非典型临床表现更为常见。

目的

确定住院老年患者中新型冠状病毒肺炎(COVID-19)的临床表现和死亡率。

材料与方法

于2020年7月1日至2021年12月31日在墨西哥城的一家综合医院开展了一项比较性横断面观察研究。纳入了60岁及以上因COVID-19诊断而住院的患者。

结果

267名老年人参与研究;53.9%为男性,中位年龄为74岁。该人群中最常见的合并症为2型糖尿病(T2DM)、高血压和慢性阻塞性肺疾病(COPD)。41.2%的患者表现出疾病的非典型症状;研究人群的死亡率为53.5%。

结论

COVID-19肺炎的非典型表现在60岁以上成年人中很常见,且随着年龄增长显著增加。肺炎典型症状的缺失以及对最常见体征的忽视可能会延迟该年龄组的诊断和及时治疗,这可能会增加并发症和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3cf/12122060/60beea5ec9a1/04435117-63-3-6350-c001.jpg

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