老年新型冠状病毒肺炎死亡患者临床特征及危险因素  

CLINICAL FEATURES AND RISK FACTORS OF ELDERLY PATIENTS WHO DIE OF CORONAVIRUS DISEASE 2019

作　　者：梁坤[1] 杨玉玲[1] 刘营[1] 刘培[1] 张翠萍[2] 毕春花[1] 边城[1] LIANG Kun;YANG Yuling;LIU Ying;LIU Pei;ZHANG Cuiping;BI Chunhua;BIAN Cheng(Department of Infectious Diseases, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院感染性疾病科,山东青岛2660031 [2]青岛大学附属医院消化内科,山东青岛266003

出　　处：《精准医学杂志》2021年第5期442-446,共5页Journal of Precision Medicine

基　　金：国家自然科学基金资助项目(RZ1900014929)。

摘　　要：目的探讨老年新型冠状病毒肺炎(COVID-19)死亡患者临床特征及其危险因素。方法选取2020年2月10—26日武汉同济医院住院的老年COVID-19患者85例,依据转归分为死亡组(33例)和治愈组(52例),回顾性分析两组患者的临床表现、实验室和影像学检查资料,探讨其临床特征及危险因素。结果死亡组患者年龄、白细胞计数、中性粒细胞计数及谷丙转氨酶、乳酸脱氢酶、D-二聚体、高敏肌钙蛋白I、IL-6水平明显高于治愈组(Z=-6.530~-4.367,P<0.05),而淋巴细胞计数、血小板计数明显低于治愈组(Z=-5.305、-5.049,P<0.05);死亡组肺部实变影的比例高于治愈组(χ^(2)=13.222,P<0.05)。死亡组qSOFA评分≥2分及CURB-65评分≥3分患者比例高于治愈组(χ^(2)=6.245、45.114,P<0.05)。多因素Logistic回归分析显示,CURB-65评分≥3分、淋巴细胞计数下降及D-二聚体水平升高可能是导致老年COVID-19患者死亡的独立危险因素。结论CURB-65评分≥3分、高D-二聚体水平及淋巴细胞计数下降可能会增加老年COVID-19患者的死亡风险。Objective To investigate the clinical features and risk factors of elderly patients who die of coronavirus di-sease 2019(COVID-19).Methods A retrospective analysis was performed for the clinical data of 85 elderly patients with COVID-19 who were hospitalized in Wuhan Tongji Hospital from February 10 to 26,2020,including clinical manifestation,laboratory results,and imaging findings,and according to prognosis,they were divided into death group with 33 patients and cured group with 52 patients.Clinical features and risk factors were analyzed.Results Compared with the cured group,the death group had significantly higher age,white blood cell count,neutrophil count,alanine aminotransferase,lactate dehydrogenase,D-dimer,cTnI,and interleukin-6(Z=-6.530--4.367,P<0.05)and significantly lower lymphocyte count and platelet count(Z=-5.305,-5.049,P<0.05).The death group had a significantly higher proportion of patients with pulmonary consolidation than the cured group(χ^(2)=13.222,P<0.05),as well as a significantly higher proportion of patients with qSOFA score≥2 or CURB-65 score≥3(χ^(2)=6.245,45.114,P<0.05).The multivariate logistic regression analysis showed that CURB-65 score≥3,reduction in lymphocyte count,and elevated D-dimer might be independent risk factors for death in elderly patients with COVID-19.Conclusion CURB-65 score≥3,a high level of D-dimer,and reduction in lymphocyte count might increase the risk of death in elderly patients with COVID-19.

关 键 词：新型冠状病毒肺炎 症状和体征 临床实验室技术 体层摄影术 X线计算机 危险因素 老年人 回顾性研究 预后 

分 类 号：R512.99[医药卫生—内科学]