COVID-19 mortality risk factors in older people in a long-term care center.
COVID-19 mortality risk factors in older people in a long-term care center.
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DOI：
10.1007/s41999-020-00432-w
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发表时间：
2021-06
影响因子：
3.8
通讯作者：
Piqué JM
中科院分区：
文献类型：
--
作者：
Heras E;Garibaldi P;Boix M;Valero O;Castillo J;Curbelo Y;Gonzalez E;Mendoza O;Anglada M;Miralles JC;Llull P;Llovera R;Piqué JM
来自长期护理中心的老年人的COVID-19死亡风险因素。男性、低Barthel指数、未接受药物治疗和淋巴细胞减少是独立的死亡危险因素。本研究中确定的独立预后因素有助于在新的COVID-19疫情爆发时调整该人群的医疗资源。尽管长期护理机构收治的老年人报告了高COVID-19感染率和相关死亡率增加，但有关这一流行病的自然过程和该人群的预后因素的信息有限。在目前的研究中，我们的目的是调查流行病学、人口统计学、临床或治疗因素，这些因素可能预测养老院中COVID-19感染的住院老年人的预后。我们对2020年3月15日至6月5日期间所有确诊COVID-19的养老院住院老人进行了回顾性分析。收集感染前的流行病学、人口统计学和虚弱状态，以及感染期间的临床、实验室、治疗和结局数据。我们使用双变量分析和多变量逻辑回归来确定死亡率的危险因素。该分析包括研究期间所有100例COVID-19确诊病例。中位年龄为85岁; 62%为女性。病死率为20%。在双变量分析中，男性、发热、呼吸道症状、严重认知功能下降、低Barthel指数和淋巴细胞减少与死亡率显著相关。与未接受药物治疗的患者相比，接受羟氯喹联合阿奇霉素治疗的患者生存率更高。多因素Logistic回归分析确定男性、低Barthel指数、未接受药物治疗和淋巴细胞减少为与死亡率相关的独立危险因素。男性、低Barthel指数和淋巴细胞减少症是长期护理养老院中住院老年患者COVID-19死亡率的独立风险因素。羟氯喹和阿奇霉素治疗与这些患者的死亡率较低相关。
COVID-19 mortality risk factors in older people from a long term care center. Male gender, low Barthel index, no pharmacological treatment and lymphocytopenia are independent mortality risk factors. The independent prognostic factors identified in the present study can help to adjust the healthcare resources in this population in case of new outbreaks of the COVID-19 pandemic. Despite high rates of COVID-19 infection and increased related mortality have been reported among older adults admitted in long-term care facilities, a limited amount of information is available about the natural course of this pandemic and prognostic factors in such population. In the current study, we aimed to investigate the epidemiologic, demographics, clinical, or therapeutic factors that may predict the prognosis in a cohort of COVID-19 infected institutionalized older in a nursing home. We conducted a retrospective analysis of all COVID-19 confirmed institutionalized older in a nursing home from March 15 to June 5, 2020. Epidemiological, demographic, and frailty status before infection, and clinical, laboratory, treatment, and outcome data during infection were collected. We used bivariate analysis and multivariate logistic regression to identify risk factors for mortality. The analysis comprised all 100 COVID-19 confirmed cases during the study period. The median age was 85 years; 62% were female. The case fatality rate was 20%. In the bivariate analysis, male gender, fever, respiratory symptoms, severe cognitive decline, a low Barthel index, and lymphocytopenia were significantly associated with mortality. Patients treated with hydroxychloroquine plus azithromycin were related to a higher chance of survival than those without pharmacological treatment. Multivariate logistic regression analysis identified male gender, low Barthel index, no pharmacological treatment, and lymphocytopenia as independent risk factors associated with mortality. Male gender, low Barthel index, and lymphocytopenia are independent risk factors for COVID-19 mortality in institutionalized older patients in long-term care nursing homes. Treatment with hydroxychloroquine and azithromycin was associated with lower mortality in these patients.
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DOI：
10.1016/j.ijantimicag.2020.105949
发表时间：
2020-07-01
影响因子：
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作者：
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