老年哮喘与COVID-19: 90天院后随访结果

Profilakticheskaya Meditsina Pub Date : 2023-01-01 DOI:10.17116/profmed20232603191

S. Avdeev, V. Gainitdinova, A. Pozdnyakova, T. Gneusheva, A. Vlasenko, I.V. Baitimerova, M. D. Samsonova

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引用次数: 0

摘要

背景。在第一波新的SARS-CoV-2冠状病毒感染之后，研究人员专注于识别COVID-19潜在的短期和长期并发症，特别是在长期住院和重症监护后的高风险患者。目标。目的:研究老年哮喘患者出院后90天重症COVID-19的结局、不良反应及其预测因素。材料和方法。该研究纳入老年患者(101例，男性42例，女性59例，中位年龄74(67;79)岁)，患有哮喘，在重症COVID-19治疗后出院。出院后随访90 d。在医院，通过实验室检测(聚合酶链反应法)和/或临床和放射学确诊COVID-19。根据GINA 2020标准，所有患者均有哮喘病史。结果和讨论。在90天的出院后随访中，86例(85%)患者存活，15例(15%)患者出院后死亡。出院后1至4周内报告死亡:6名受试者在再次住院期间死亡，6名在家中死亡，3名在康复中心死亡。多变量回归分析模型，调整了所有具有统计学意义的指标，ROC分析显示了90天后死亡率的最显著预测因子及其阈值。包括Charlson合病指数>=4分，ct示肺损伤>=30%，ct示嗜酸性粒细胞绝对数量=30%，嗜酸性粒细胞绝对数量<=100细胞/ μ l，合并糖尿病。90天的住院后生存率与患者确定的危险因素的数量相关。未观察哮喘严重程度对老年患者院后90天死亡率的影响。版权所有©Media Sphera出版集团2023版权所有。

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Asthma in the elderly and COVID-19: results of the 90-day post-hospital follow-up

Background. After the first wave of the new SARS-CoV-2 coronavirus infection, the researchers focused on identifying potential short-and long-term complications of COVID-19, especially in high-risk patients, after prolonged hospitalization and intensive care. Objective. To study the outcomes, adverse effects of severe COVID-19 and their predictors 90 days after hospital discharge in elderly patients with asthma. Material and methods. The study included elderly patients (101 subjects, 42 males and 59 females;median age 74 (67;79) years) with asthma, discharged from the hospital after treatment of severe COVID-19. They were followed up for 90 days after discharge. In the hospital, COVID-19 was confirmed by laboratory tests (polymerase chain reaction method) and/or clinically and radiologically. All patients had a documented history of asthma according to GINA 2020 criteria. Results and discussion. During the 90-day post-hospital follow-up, 86 (85%) patients survived, and 15 (15%) died after discharge. Deaths were reported within 1 to 4 weeks after discharge: 6 subjects died during re-hospitalization, 6 at home, and 3 in a rehabilitation center. The multivariate regression analysis model, adjusted for all statistically significant indicators, and the ROC analysis showed the most significant predictors of 90-day post-hospital mortality and their threshold values. They include the Charlson comorbidity index >=4 points, lung damage according to computed tomography >=30%, the absolute number of eosinophils <=100 cells/muL, and concomitant diabetes mellitus. The analysis showed that 90-day post-hospital mortality depends on combinations of identified risk factors;a combination of two, three, and especially four risk factors statistically significantly is associated with patients' lower average survival time. Conclusion. The key risk factors for 90-day post-hospital mortality in elderly patients with asthma after severe COVID-19 include the Charlson comorbidity index, lung damage >=30% according to computed tomography, the absolute number of eosinophils <=100 cells/muL, and concomitant diabetes mellitus. The 90-day post-hospital survival rate is correlated with the number of risk factors identified in patients. The effect of asthma severity on 90-day post-hospital mortality in elderly patients was not observed.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

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来源期刊

Profilakticheskaya Meditsina Medicine-Health Policy

CiteScore

0.90

自引率

0.00%

发文量

108

期刊介绍： The journal "Profilakticheskaya meditsina" (The Russian Journal of Preventive Medicine and Public Health) has been published since 1997 and is intended for healthcare professionals and administrators, politicians, and scientists. A wide range of problems appearing on the pages of the journal is determined by its sociopolitical and scientific-and-practical orientations. The journal covers the problems of health promotion, the prevention and treatment of communicable and non-communicable diseases, such as cardiovascular and respiratory diseases, cancers, diabetes, injuries, and violent death. The main sections of the journal: Organization of Public Health Prevention of Communicable and Non-Communicable Diseases, Health Promotion: Policy and Strategy Sociomedical Aspects of Health Formation Medico-Demographic Aspects of Health Formation Prevention of Communicable and Non-Communicable Diseases Risk Factors for Communicable and Non-Communicable Diseases The Health of Children, Adolescents, and Young People Female Health Male Health Nutrition and Health Smoking and Health Alcohol and Health Guidelines for the Specialist Education Programs for Healthcare Specialists and Patients Experience of Regions A Specialist’s Opinion Reviews.