老年Omicron新冠病毒感染臨床特徵分析

Analysis of clinical characteristics of Omicron COVID-19 infection in the elderly

目的分析新冠Omicron流行期間,成年新冠感染者的臨床特徵及預後,提高對老年人、特別是長壽老人感染Omicron病毒株的臨床認識,以提高臨床救治水準。方法收集2022年12月18日~2023年2月2日在澳門地區某醫院確診新冠感染住院患者的臨床資料,按年齡分為青年老年組、老老年組和長壽老年組,從合併基礎疾病、MEWS評分、體溫、血常規、診斷、治療、住院天數及預後等方面和中青年組進行對照分析。結果患者年齡18歲~109歲,平均年齡(76.18±18.14)歲,212例(22.6%)為≥90歲的長壽老年人,本組平均年齡(94.52±3.56)歲,重症及危重症佔94.5%,95.3%的患者至少合併1種基礎疾病。對照組好轉出院132例,佔95.7%,而90歲及以上組好轉出院160例,佔76.5%(χ2=33.9,P<0.05)。結論新冠Omicron感染者,老年人重症率高,好轉出院率低,特別是90歲及以上長壽老人,是新冠防疫和救治的重點人群。

Objective To analyze the clinical features and outcomes of COVID-19 infection in elderly patients during the 5th wave COVID-19 subtype Omicron epidemic period in Macao in order to improve the ability of diagnosis and treatment.Methods The clinical data of omicron infected patientsfrom December-18-2022 to February-02-2023 were collected.A retrospective study was used to compare the elderly patients and young to middle-aged patients.The cases were confirmed based on the clinical features,positive result in rapid COVID-19 antigen test or real time reverse-transcriptase polymerase chain.Results The mean age of the total 939 patients was(76.18±18.14)years old,and the age range was 18 to 109 years old.A total of 22.6%were older than 90 years,94.5%of them were severe or critical patients,and 95.3%had at least combined with one pre-existing disease.The improved discharge rate in the very old group was 76.5%,lower than that of 96.4%in young to middle-aged group(χ2=33.9,P<0.05).Conclusion The elderly patients infected with Omicron,especially very old patients,have a higher rate of severe or critical illness and a lower rate of improved discharge.They are still the key population for the elderly prevention and treatment in the future.