武汉地区老年新型冠状病毒肺炎临床特征及危险因素分析

宋开心.武汉地区老年新型冠状病毒肺炎临床特征及危险因素分析[J].内科急危重症杂志,2025,31(1):36-39

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DOI：10.11768/nkjwzzzz20250105

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基金项目:国家自然科学基金青年项目(81800603)

作者	单位	E-mail
宋开心	华中科技大学同济医学院附属协和医院	hygao@tjh.tjmu.edu.cn

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中文摘要:

摘要目的：分析武汉地区老年新型冠状病毒肺炎住院患者的临床特征及死亡相关的危险因素。方法：本研究为回顾性临床队列研究。收集住院治疗的新型冠状病毒肺炎患者的临床资料，对研究对象进行临床数据采集、分组、临床特征研究及死亡相关危险因素分析。结果：共纳入1857例新型冠状病毒肺炎患者,其中老年（65岁）患者893例，非老年（<65岁）患者964例。与非老年患者比较，老年患者出现发热、咳嗽、肌肉痛或疲劳、呼吸困难症状的比例更高（P均<0.005）;白细胞计数、中性粒细胞计数、D二聚体、乳酸脱氢酶、血肌酐、尿素氮、肌钙蛋白I、N末端脑钠肽前体、高敏C反应蛋白、降钙素原及血沉水平更高；淋巴细胞计数、血红蛋白、白蛋白水平更低(P均<0.001)；出现休克、急性呼吸窘迫综合征、进行机械通气治疗及死亡的比例更高(P均<0.001)。逻辑回归分析显示，年龄、白细胞计数升高、淋巴细胞计数减少、乳酸脱氢酶升高、血小板计数减少、超敏C反应蛋白升高及合并呼吸系统基础疾病是老年新型冠状病毒肺炎患者死亡相关的危险因素(P均<0.05)。结论:老年新型冠状病毒肺炎患者出现发热、咳嗽、肌肉痛或疲劳、呼吸困难的比例高，更易出现休克、ARDS的并发症，死亡率高。年龄、白细胞计数升高、淋巴细胞计数减少、乳酸脱氢酶升高、血小板计数减少、超敏C反应蛋白升高、合并呼吸系统基础疾病是与老年患者死亡相关的危险因素。

英文摘要:

Abstract Objective: To analyze the clinical characteristics and risk factors for mortality of elderly inpatients with Coronavirus disease 2019 (COVID-19) in Wuhan. Methods: A retrospective cohort study was performed. Clinical data of hospitalized patients with COVID-19 were collected, and these patients were grouped. The clinical characteristics and death related risk factors were analyzed. Results: There were 1857 COVID-19 patients enrolled in our study, including 893 elderly patients and 964 non-elderly patients. The main symptoms of elderly patients were fever, cough, myalgia or fatigue and shortness of breath (all P <0.005). The white blood cell count, neutrophil count, D-Dimer, lactate dehydrogenase (LDH), serum creatinine (Scr), blood urea nitrogen (BUN), cardiac troponin I (cTnI), NT-pro brain natriuretic peptide (NT-proBNP), high sensitivity C reactive protein (hs-CRP), procalcitonin (PCT) and erythrocyte sedimentation rate (ESR) in elderly patients were higher than those in non-elderly patients (all P<0.001). Meanwhile, the lymphocyte count, hemoglobin and albumin were lower in elderly patients than those in non-elderly patients (all P< 0.001). Moreover, the elderly patients were more prone to develop to shock, acute respiratory distress syndrome (ARDS); and had a higher percentage to treatment with mechanical ventilation and death (all P< 0.001). In addition, the logistic regression analysis indicated age, increased count of white cells, decreased count of lymphocytes, increased LDH, decreased count of platelets, increased hsCRP, preexisting of chronic respiratory disease were the risk factors for death in elderly patients with COVID-19 (all P< 0.05). Conclusion: The main symptoms of elderly patients with COVID-19 were fever, cough, myalgia or fatigue and shortness of breath; and the elderly patients were more prone to develop to shock and ARDS, with a higher mortality rate. Moreover, age, increased count of white blood cells, decreased count of lymphocytes, increased LDH, decreased count of platelets, increased hsCRP, preexisting of chronic respiratory disease were the risk factors for death among COVID-19 elderly patients.