老年COVID-19患者合并症、实验室检查和临床结果的评估

G. Cakirca, Tuba Damar Çakırca
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摘要

背景:本研究旨在分析老年COVID-19感染患者的基础疾病、实验室检查结果和临床转归。我们还研究了实验室参数在估计老年危重病例和死亡率中的价值。材料与方法:本研究纳入314例60岁及以上诊断为COVID-19的老年患者。患者按年龄分为两组,分别为年轻老年患者(60-74岁)和老年老年患者(≥75岁)。参与者的年龄、性别、潜在疾病、实验室结果、疾病严重程度和生存数据从医院记录中获得。结果:老年患者最常见的合并症为高血压(57.6%)、糖尿病(33.8%)和心血管疾病(28%)。老年危重型(63.4% vs 30.8%, P<0.001)和病死率(41.9% vs 21.3%, P<0.001)高于年轻老年患者。老年组白细胞计数、中性粒细胞计数、尿素、肌酐、c反应蛋白(CRP)、降钙素原、铁蛋白、肌钙蛋白T、肌酸激酶mb、凝血酶原时间、d -二聚体值均高于年轻老年组。相比之下,老年组血红蛋白和白蛋白值较低。白蛋白、CRP、降钙素原、铁蛋白、肌钙蛋白T、凝血酶原时间曲线下面积(AUC)均大于0.80,可用于预测老年危重患者。铁蛋白预测死亡的AUC最高(AUC: 0.819),其次是CRP (AUC: 0.805)和降钙素原(AUC: 0.796)。结论:我们发现与年轻老年患者相比,老年患者的危重型和死亡率更高。此外,铁蛋白、CRP和降钙素原是covid -19感染老年受试者疾病严重程度和死亡率的强预测因子。
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Evaluation of Comorbidities, Laboratory Findings and Clinical Outcomes in Elderly Patients with COVID-19
Background: In this study, we aimed to analyze the underlying diseases, laboratory findings and clinical outcomes of elderly patients infected with COVID-19. We also investigated the value of laboratory parameters in the estimation of critical cases and mortality in elderly patients. Materials and Methods: The study included 314 elderly patients aged 60 years and older who were diagnosed with COVID-19.The patients were divided into two groups according to age, as young old patients (60-74 years) and old old patients (≥75 years). Participants' age, gender, underlying diseases, laboratory findings, disease severity and survival data were obtained from hospital records. Results: The most common comorbidities in elderly patients were hypertension (57.6%), diabetes mellitus (33.8%) and cardiovascular disease (28%). Old old patients had higher rates of critical type (63.4% vs 30.8%, P<0.001) and death (41.9% vs 21.3%, P<0.001) compared to young old patients. The leukocyte count, neutrophil count, urea, creatinine, C-reactive protein (CRP), procalcitonin, ferritin, troponin T, creatine kinase-MB, prothrombin time and D-dimer values were higher in the old old group compared to the young old group. In contrast, hemoglobin and albumin values were lower in the old old group. The areas under the curve (AUC) of albumin, CRP, procalcitonin, ferritin, troponin T and prothrombin time were greater than 0.80 to predict critically elderly COVID-19 patients. Ferritin had the highest AUC for predicting death (AUC: 0.819) followed by CRP (AUC: 0.805) and procalcitonin (AUC: 0.796). Conclusions: We found higher rates of critical type and death in old old patients compared to young old patients. In addition, ferritin, CRP, and procalcitonin were strong predictors of both disease severity and mortality in COVID-19-infected elderly subjects.
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