Age differences in the association of comorbid burden with adverse outcomes in SARS-CoV-2.
Age differences in the association of comorbid burden with adverse outcomes in SARS-CoV-2.
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DOI：
10.1186/s12877-021-02340-5
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发表时间：
2021-07-06
期刊：
影响因子：
4.1
通讯作者：
Ioannou GN
中科院分区：
文献类型：
--
作者：
O'Hare AM;Berry K;Fan VS;Crothers K;Eastment MC;Dominitz JA;Shah JA;Green P;Locke E;Ioannou GN
老年和共病负担都与SARS-CoV-2的不良结局相关，但尚不清楚共病负担与不良结局之间的关联在老年人和年轻人中是否不同。比较不同年龄（18 - 64岁、65 - 79岁和≥ 80岁）成人SARS-CoV-2患者的共病负担与不良结局之间的关系。对170，528名在2020年2月28日至2020年12月31日期间在美国退伍军人事务部（VA）医疗保健系统检测为SARS-CoV-2阳性的患者进行的观察性纵向队列研究，这些患者随访至2021年1月31日。Charlson并发症指数（CCI）; SARS-CoV-2检测阳性后30天内住院、重症监护室（ICU）入院、机械通气和死亡的发生率。在<65岁的队列成员中，累积30天死亡发生率为0.8%，在65 - 79岁的队列成员中为7.1%，在≥ 80岁的队列成员中为20.6%。30天住院率分别为8.2%、21.7%和29.5%，ICU入院率分别为2.7%、8.6%和11%，机械通气率分别为1%、3.9%和3.2%。中位CCI（四分位距）范围从最年轻组的0.0（0.0，2.0）到最年长组的4（2.0，7.0）。CCI与所有结局的校正相关性在年龄较大时减弱，因此CCI阈值水平（超过该阈值，每个结局的风险超过参考组（第一四分位数））在年轻队列成员中低于老年队列成员（所有年龄组相互作用p <0.001）。CCI是根据诊断代码计算的，可能无法准确评估共病负担。年龄差异在总体共病负担的分布和预后意义上可以为大流行期间的临床管理、疫苗接种优先顺序和人群健康提供信息，并主张开展更多工作来了解年龄和共病在塑造SARS-CoV-2住院患者护理中的作用。在线版本包含补充材料，可通过10.1186/s12877 - 021 - 02340 - 5获得。
Older age and comorbid burden are both associated with adverse outcomes in SARS-CoV-2, but it is not known whether the association between comorbid burden and adverse outcomes differs in older and younger adults. To compare the relationship between comorbid burden and adverse outcomes in adults with SARS-CoV-2 of different ages (18–64, 65–79 and ≥ 80 years). Observational longitudinal cohort study of 170,528 patients who tested positive for SARS-CoV-2 in the US Department of Veterans Affairs (VA) Health Care System between 2/28/20 and 12/31/2020 who were followed through 01/31/2021. Charlson Comorbidity Index (CCI); Incidence of hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death within 30 days of a positive SARS-CoV-2 test. The cumulative 30-day incidence of death was 0.8% in cohort members < 65 years, 7.1% in those aged 65–79 years and 20.6% in those aged ≥80 years. The respective 30-day incidences of hospitalization were 8.2, 21.7 and 29.5%, of ICU admission were 2.7, 8.6, and 11% and of mechanical ventilation were 1, 3.9 and 3.2%. Median CCI (interquartile range) ranged from 0.0 (0.0, 2.0) in the youngest, to 4 (2.0, 7.0) in the oldest age group. The adjusted association of CCI with all outcomes was attenuated at older ages such that the threshold level of CCI above which the risk for each outcome exceeded the reference group (1st quartile) was lower in younger than in older cohort members (p < 0.001 for all age group interactions). The CCI is calculated based on diagnostic codes, which may not provide an accurate assessment of comorbid burden. Age differences in the distribution and prognostic significance of overall comorbid burden could inform clinical management, vaccination prioritization and population health during the pandemic and argue for more work to understand the role of age and comorbidity in shaping the care of hospitalized patients with SARS-CoV-2. The online version contains supplementary material available at 10.1186/s12877-021-02340-5.
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DOI：
10.15585/mmwr.mm6915e3
发表时间：
2020-04-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Garg S;Kim L;Whitaker M;O'Halloran A;Cummings C;Holstein R;Prill M;Chai SJ;Kirley PD;Alden NB;Kawasaki B;Yousey-Hindes K;Niccolai L;Anderson EJ;Openo KP;Weigel A;Monroe ML;Ryan P;Henderson J;Kim S;Como-Sabetti K;Lynfield R;Sosin D;Torres S;Muse A;Bennett NM;Billing L;Sutton M;West N;Schaffner W;Talbot HK;Aquino C;George A;Budd A;Brammer L;Langley G;Hall AJ;Fry A
通讯作者：
Fry A
影响因子：
6.3
作者：
Farrell, Timothy W.;Ferrante, Lauren E.;Saliba, Debra
通讯作者：
Saliba, Debra
影响因子：
34.3
作者：
Baqui, Pedro;Bica, Ioana;van der Schaar, Mihaela
通讯作者：
van der Schaar, Mihaela
影响因子：
3.7
作者：
Chatterjee A;Wu G;Primakov S;Oberije C;Woodruff H;Kubben P;Henry R;Aries MJH;Beudel M;Noordzij PG;Dormans T;Gritters van den Oever NC;van den Bergh JP;Wyers CE;Simsek S;Douma R;Reidinga AC;de Kruif MD;Guiot J;Frix AN;Louis R;Moutschen M;Lovinfosse P;Lambin P
通讯作者：
Lambin P
影响因子：
39
作者：
Gupta, Shruti;Hayek, Salim S.;Leaf, David E.
通讯作者：
Leaf, David E.