COVID-19老年患者临床特征及影响因素分析

来源 :中华实验和临床病毒学杂志 | 被引量 : 0次 | 上传用户:qcolin
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目的:分析新型冠状病毒肺炎(COVID-19)老年患者临床特征及预后影响因素,为临床诊治提供参考依据。方法:回顾性分析确诊COVID-19住院患者109例,其中老年组39例,非老年组70例,比较两组的各项临床资料及预后。结果:COVID-19老年组发生重型、危重型比例高于非老年组[48.7%(19/39)]比[15.7%(11/70)],n P=0.032。老年组有慢性基础病患者比例明显高于非老年组[84.6%(33/39) ]比[30%(21/70)],n P=0.003。老年组伴有胸闷15例(38.5%)、喘憋12例(30.8%)高于非老年组胸闷13例(18.6%)、喘憋3例(43%),n P<0.05。实验室检查指标中老年组外周血淋巴细胞绝对计数比非老年组明显降低(n P=0.029)。老年组C-反应蛋白、粒淋比(NLR)比非老年组明显升高(n P<0.001)。老年组丙氨酸氨基转移酶(ALT)、谷氨酸氨基转移酶(AST)、白蛋白(ALB)、肌酐(CREA)、肌酸激酶(CK)、肌红蛋白(MYO)异常值高于非老年组(n P<0.05)。其中年龄、基础病、NLR是影响预后的独立危险因素。n 结论:COVID-19老年组患者常合并多种基础病,更易出现心、肝、肾功能异常,更易发展为重型、危重型病例。影响预后的因素包括年龄大于60岁、有基础病和血清NLR水平。“,”Objective:To Analyze the clinical features and influencing factors of elderly patients with new coronavirus pneumonia (COVID-19) and provide reference for clinical diagnosis and treatment.Methods:A retrospective analysis was performed for 109 inpatients diagnosed with COVID-19, including 39 in the elderly group and 70 in the non-elderly group, and the clinical data and prognosis of the two groups were compared.Results:The incidence of severe and critical cases in the elderly group was higher than that in the non-elderly group [48.7% (19/39)] n vs.[15.7%(11/70)], n P=0.032. The proportion of patients with chronic underlying diseases in the elderly group was significantly higher than that in the non-elderly group [84.6% (33/39)] n vs. [30% (21/70)], n P=0.003. There were 15 cases with chest tightness in the elderly group (38.5%), 12 cases of wheezing (30.8%) which were significantly higher than those in the non-elderly group. The laboratory examination tests of elderly groups showed a significantly lower absolute count of peripheral blood lymphocytes than non-elderly groups, and there was a significant difference (n P=0.029), and C-reactive protein and Neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the elderly group than that of non-elderly groups (n P<0.001). The abnormal value of alanine aminotransferase (ALT), aspartate aminotransferase (AST), Albumin (ALB), creatinine (CREA), creatine kinase (CK), myoglobin (MYO) in the elderly group were higher than those in the non-elderly group (n P<0.05). Age, underlying disease, NLR are independent risk factors affecting prognosis.n Conclusions:Elderly patients with the COVID-19 often have multiple underlying diseases, if the rates of laboratory lymphocyte count, C-reactive protein, liver and kidney function and myocardial enzyme spectrum abnormalities increased more obviously, the patients are more likely to develop into severe and critical status. Factors affecting the prognosis include age greater than 60 years, presence of underlying disease and serum NLR levels.
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