Clinical Characteristics and Outcomes of Elderly COVID-19 Patients Admitted to ICU during Chinese Mainland's Omicron Wave: A Multicenter Retrospective Cohort Study.

IF 3.1 3区医学 Q3 GERIATRICS & GERONTOLOGY

Gerontology Pub Date : 2025-03-29 DOI:10.1159/000545536

Ziying Chen, Linna Huang, Qi Zhang, Yuqiong Wang, Guohui Fan, Xu Huang, Min Li, Sichao Gu, Yi Zhang, Yingying Feng, Ye Tian, Xiaoyang Cui, Ying Cai, Tianshu Zhai, Xianxia Zhuo, Xiaojing Wu, Bin Cao, Qingyuan Zhan

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引用次数: 0

Abstract

Introduction: There is limited information on elderly patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infections. We aimed to describe the characteristics and outcomes of elderly patients with Omicron variant infections admitted to the intensive care unit (ICU) on the Chinese mainland and to evaluate the risk factors associated with mortality in these patients.

Methods: We conducted a multicenter retrospective study including elderly patients with SARS-CoV-2 infection who were admitted to the ICU from November 1, 2022, to February 11, 2023, on the Chinese mainland. The primary objective of the study was to describe the characteristics and outcomes of elderly ICU patients with Omicron variant infections. The secondary objective was to evaluate the risk factors for mortality of these patients.

Results: We included 1,605 patients aged 65 years or older diagnosed with severe or critical COVID-19 and admitted to ICUs in 59 hospitals across different areas of the Chinese mainland. The median age was 78 years (P25-P75, 72-84), with male patients accounting for 1,164/1,605 (72.5%) and 1,459/1,605 (90.9%) of patients having at least one comorbidity. The median APACHE II scores and SOFA scores were 16 (P25-P75, 11-23) and 5 (P25-P75, 3-8), respectively. Among these patients, 553 (34.5%) were recovery discharged, 557 (34.7%) died in the ICUs, and 495 (30.8%) discharged voluntarily during therapy and were later confirmed dead after discharge. Multivariable logistics analysis indicated that older age, coinfection, high levels of white blood cell count, blood urea nitrogen, D-dimer, and lactate at admission were against for recovery discharged.

Conclusions: Elderly patients infected with the Omicron variant of SARS-CoV-2 and admitted to the ICU had a considerable mortality rate. Better understanding of risk factors for mortality may improve clinical management and more rational allocation of limited medical resources during a COVID-19 surge.

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中国大陆欧米克隆波期间入住ICU的老年COVID-19患者临床特征及结局：一项多中心回顾性队列研究

关于老年严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）组粒变异感染的信息有限。我们的目的是描述中国大陆重症监护病房（ICU）收治的老年欧米克隆变异感染患者的特征和结局，并评估与这些患者死亡相关的危险因素。方法：对2022年11月1日至2023年2月11日在中国大陆ICU住院的老年SARS-CoV-2感染患者进行多中心回顾性研究。本研究的主要目的是描述老年ICU患者欧米克隆变异感染的特征和结局。次要目的是评估这些患者死亡的危险因素。结果：我们纳入中国大陆不同地区59家医院重症监护病房的1605例65岁及以上确诊为重症或危重型COVID-19患者。中位年龄为78岁（P25-P75, 72-84），男性患者占1164/1605(72.5%),1459/1605（90.9%）患者至少有一种合并症。APACHE II评分和SOFA评分中位数分别为16 （P25-P75, 11-23）和5 （P25-P75, 3-8）。其中恢复出院553例（34.5%），icu死亡557例（34.7%），治疗期间自愿出院，出院后确认死亡495例（30.8%）。多变量logistic分析表明，年龄较大、合并感染、入院时白细胞计数、血尿素氮、d -二聚体、乳酸水平高不利于康复出院。结论：老年SARS-CoV-2欧米克隆变型感染患者入住ICU的死亡率较高。更好地了解死亡风险因素可以改善临床管理，并在COVID-19激增期间更合理地分配有限的医疗资源。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gerontology 医学-老年医学

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： In view of the ever-increasing fraction of elderly people, understanding the mechanisms of aging and age-related diseases has become a matter of urgent necessity. ''Gerontology'', the oldest journal in the field, responds to this need by drawing topical contributions from multiple disciplines to support the fundamental goals of extending active life and enhancing its quality. The range of papers is classified into four sections. In the Clinical Section, the aetiology, pathogenesis, prevention and treatment of agerelated diseases are discussed from a gerontological rather than a geriatric viewpoint. The Experimental Section contains up-to-date contributions from basic gerontological research. Papers dealing with behavioural development and related topics are placed in the Behavioural Science Section. Basic aspects of regeneration in different experimental biological systems as well as in the context of medical applications are dealt with in a special section that also contains information on technological advances for the elderly. Providing a primary source of high-quality papers covering all aspects of aging in humans and animals, ''Gerontology'' serves as an ideal information tool for all readers interested in the topic of aging from a broad perspective.