Asthma in the elderly and COVID-19: results of the 90-day post-hospital follow-up
S. Avdeev, V. Gainitdinova, A. Pozdnyakova, T. Gneusheva, A. Vlasenko, I.V. Baitimerova, M. D. Samsonova
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Abstract
Background. After the first wave of the new SARS-CoV-2 coronavirus infection, the researchers focused on identifying potential short-and long-term complications of COVID-19, especially in high-risk patients, after prolonged hospitalization and intensive care. Objective. To study the outcomes, adverse effects of severe COVID-19 and their predictors 90 days after hospital discharge in elderly patients with asthma. Material and methods. The study included elderly patients (101 subjects, 42 males and 59 females;median age 74 (67;79) years) with asthma, discharged from the hospital after treatment of severe COVID-19. They were followed up for 90 days after discharge. In the hospital, COVID-19 was confirmed by laboratory tests (polymerase chain reaction method) and/or clinically and radiologically. All patients had a documented history of asthma according to GINA 2020 criteria. Results and discussion. During the 90-day post-hospital follow-up, 86 (85%) patients survived, and 15 (15%) died after discharge. Deaths were reported within 1 to 4 weeks after discharge: 6 subjects died during re-hospitalization, 6 at home, and 3 in a rehabilitation center. The multivariate regression analysis model, adjusted for all statistically significant indicators, and the ROC analysis showed the most significant predictors of 90-day post-hospital mortality and their threshold values. They include the Charlson comorbidity index >=4 points, lung damage according to computed tomography >=30%, the absolute number of eosinophils <=100 cells/muL, and concomitant diabetes mellitus. The analysis showed that 90-day post-hospital mortality depends on combinations of identified risk factors;a combination of two, three, and especially four risk factors statistically significantly is associated with patients' lower average survival time. Conclusion. The key risk factors for 90-day post-hospital mortality in elderly patients with asthma after severe COVID-19 include the Charlson comorbidity index, lung damage >=30% according to computed tomography, the absolute number of eosinophils <=100 cells/muL, and concomitant diabetes mellitus. The 90-day post-hospital survival rate is correlated with the number of risk factors identified in patients. The effect of asthma severity on 90-day post-hospital mortality in elderly patients was not observed.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
老年哮喘与COVID-19: 90天院后随访结果
背景。在第一波新的SARS-CoV-2冠状病毒感染之后,研究人员专注于识别COVID-19潜在的短期和长期并发症,特别是在长期住院和重症监护后的高风险患者。目标。目的:研究老年哮喘患者出院后90天重症COVID-19的结局、不良反应及其预测因素。材料和方法。该研究纳入老年患者(101例,男性42例,女性59例,中位年龄74(67;79)岁),患有哮喘,在重症COVID-19治疗后出院。出院后随访90 d。在医院,通过实验室检测(聚合酶链反应法)和/或临床和放射学确诊COVID-19。根据GINA 2020标准,所有患者均有哮喘病史。结果和讨论。在90天的出院后随访中,86例(85%)患者存活,15例(15%)患者出院后死亡。出院后1至4周内报告死亡:6名受试者在再次住院期间死亡,6名在家中死亡,3名在康复中心死亡。多变量回归分析模型,调整了所有具有统计学意义的指标,ROC分析显示了90天后死亡率的最显著预测因子及其阈值。包括Charlson合病指数>=4分,ct示肺损伤>=30%,ct示嗜酸性粒细胞绝对数量=30%,嗜酸性粒细胞绝对数量<=100细胞/ μ l,合并糖尿病。90天的住院后生存率与患者确定的危险因素的数量相关。未观察哮喘严重程度对老年患者院后90天死亡率的影响。版权所有©Media Sphera出版集团2023版权所有。
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