Rick factors influencing the prognosis of elderly patients infected with COVID-19: a clinical retrospective study in Wuhan, China
Rick factors influencing the prognosis of elderly patients infected with COVID-19: a clinical retrospective study in Wuhan, China
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DOI：
10.18632/aging.103631
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发表时间：
2020-07-15
期刊：
影响因子：
5.2
通讯作者：
Peng, Jian
中科院分区：
文献类型：
--
作者：
Gao, Shan;Jiang, Fang;Peng, Jian
2019冠状病毒病（COVID-19）老年患者的死亡率显著高于整体死亡率。然而，除了年龄，导致老年患者高死亡率的主要死亡危险因素仍未确定。这项回顾性研究纳入了210名老年COVID-19患者（年龄65岁），其中175名患者出院，35名患者死亡。所有死亡患者至少有一种合并症。死亡组中患有心血管疾病（49% vs. 20%）、呼吸系统疾病（51% vs. 11%）、慢性肾脏疾病（29% vs. 5%）和脑血管疾病（20% vs. 3%）的患者比例明显高于出院组。死亡组的C反应蛋白（125.8mg/L vs. 9.3mg/L）和血尿素氮（7.2mmol/L vs. 4.4mmol/L）的中位数水平显著高于出院组，淋巴细胞计数中位数（0.7x10（9）/L vs. 1.1x10（9）/L）显著低于出院组。生存曲线分析显示，较高的C反应蛋白（nmg/L）加上淋巴细胞、血尿素氮或乳酸脱氢酶的任何其他异常均显著预测COVID-19感染的老年患者预后不良。本研究显示，这些老年患者死亡的危险因素包括合并症、C反应蛋白和血尿素氮水平升高以及住院期间淋巴细胞减少。
The mortality rate of elderly patients with Coronavirus Disease 2019 (COVID-19) was significantly higher than the overall mortality rate. However, besides age, leading death risk factors for the high mortality in elderly patients remain unidentified. This retrospective study included 210 elderly COVID-19 patients (aged 65 years), of whom 175 patients were discharged and 35 died. All deceased patients had at least one comorbidity. A significantly higher proportion of patients in the deceased group had cardiovascular diseases (49% vs. 20%), respiratory diseases (51% vs. 11%), chronic kidney disease (29% vs. 5%) and cerebrovascular disease (20% vs. 3%) than that in the discharged group. The median levels of C-reactive protein (125.8mg/L vs. 9.3mg/L) and blood urea nitrogen (7.2mmol/L vs. 4.4mmol/L) were significantly higher and median lymphocyte counts (0.7x10(9)/L vs. 1.1x10(9)/L) significantly lower in the deceased group than those in the discharged group. The survival curve analysis showed that higher C-reactive protein (nmg/L) plus any other abnormalities of lymphocyte, blood urea nitrogen or lactate dehydrogenase significantly predicted poor prognosis of COVID-19 infected elderly patients. This study revealed that the risk factors for the death in these elderly patients included comorbidities, increased levels of C-reactive protein and blood urea nitrogen, and lymphopenia during hospitalization.