PDF(Pubmed)
Abstract：
Among patients over 75 years, little is known about functional decline due to COVID-19. The aim of this study was to explore this functional decline, compare to other infectious pneumonia.
This case-control study included all COVID-19 patients hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital matched 1/1 with patients with pneumonia hospitalized in geriatric department between March 2017 and March 2019 (controls) on sex, age. Functional decline was assessed at 3 month follow up as it is routinely done after hospitalization in geriatric ward. We performed multivariable analyses to compare clinical outcomes between patients with COVID-19 vs controls.
132 pairs were matched on age (mean: 87 y-o), and sex (61% of women). In multivariable logistic regression analysis, there were no statistical significant association between COVID-19 infection and functional decline (OR=0.89 p=0.72). A statistical significant association was found between functional decline and Charlson comorbidity index (OR=1.17, p=0.039); prior fall (OR=2.08, p=0.012); malnutrition (OR=1.97, p=0.018); length of hospital stay (OR=1.05, p=0.002) and preadmission ADL(OR=1.25, p=0.049).
COVID-19 does not seem to be responsible for a more frequent or severe functional decline than other infectious pneumonia in older and comorbid population after 3 month follow up. In this population, pneumonia is associated with functional decline in almost 1 in 2 cases. The individual preadmission frailty seems to be a more important predictor of functional decline, encouraging multidimensional care management for this population.
This case-control study included all COVID-19 patients hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital matched 1/1 with patients with pneumonia hospitalized in geriatric department between March 2017 and March 2019 (controls) on sex, age. Functional decline was assessed at 3 month follow up as it is routinely done after hospitalization in geriatric ward. We performed multivariable analyses to compare clinical outcomes between patients with COVID-19 vs controls.
132 pairs were matched on age (mean: 87 y-o), and sex (61% of women). In multivariable logistic regression analysis, there were no statistical significant association between COVID-19 infection and functional decline (OR=0.89 p=0.72). A statistical significant association was found between functional decline and Charlson comorbidity index (OR=1.17, p=0.039); prior fall (OR=2.08, p=0.012); malnutrition (OR=1.97, p=0.018); length of hospital stay (OR=1.05, p=0.002) and preadmission ADL(OR=1.25, p=0.049).
COVID-19 does not seem to be responsible for a more frequent or severe functional decline than other infectious pneumonia in older and comorbid population after 3 month follow up. In this population, pneumonia is associated with functional decline in almost 1 in 2 cases. The individual preadmission frailty seems to be a more important predictor of functional decline, encouraging multidimensional care management for this population.
摘要：
目标：在75岁以上的患者中，对COVID-19导致的功能下降知之甚少。这项研究的目的是探索这种功能下降，与其他感染性肺炎相比。
方法：这项病例对照研究纳入了2020年3月至12月在南特大学医院急性老年病房住院的所有COVID-19患者，其中1/1与2017年3月至2019年3月在老年科住院的肺炎患者（对照）性别匹配，年龄。在老年病房住院后常规进行的3个月随访时评估功能下降。我们进行了多变量分析，以比较COVID-19患者与对照组的临床结局。
结果：132对年龄匹配（平均值：87岁），和性别（61%的女性）。在多变量逻辑回归分析中，COVID-19感染与功能下降之间无统计学显著关联(OR=0.89p=0.72).发现功能下降与Charlson合并症指数（OR=1.17，p=0.039）；跌倒前（OR=2.08，p=0.012）；营养不良（OR=1.97，p=0.018）；住院时间（OR=1.05，p=0.002）和入院前ADL（OR=1.25，p=0.049）之间存在统计学上的显着关联。
结论：在3个月的随访后，与其他感染性肺炎相比，COVID-19似乎不会导致更频繁或更严重的功能下降。在这个人群中,肺炎与2例患者中几乎1例的功能减退有关.个人入院前的虚弱似乎是功能下降的更重要的预测因子，鼓励对这一人群进行多维护理管理。
方法：这项病例对照研究纳入了2020年3月至12月在南特大学医院急性老年病房住院的所有COVID-19患者，其中1/1与2017年3月至2019年3月在老年科住院的肺炎患者（对照）性别匹配，年龄。在老年病房住院后常规进行的3个月随访时评估功能下降。我们进行了多变量分析，以比较COVID-19患者与对照组的临床结局。
结果：132对年龄匹配（平均值：87岁），和性别（61%的女性）。在多变量逻辑回归分析中，COVID-19感染与功能下降之间无统计学显著关联(OR=0.89p=0.72).发现功能下降与Charlson合并症指数（OR=1.17，p=0.039）；跌倒前（OR=2.08，p=0.012）；营养不良（OR=1.97，p=0.018）；住院时间（OR=1.05，p=0.002）和入院前ADL（OR=1.25，p=0.049）之间存在统计学上的显着关联。
结论：在3个月的随访后，与其他感染性肺炎相比，COVID-19似乎不会导致更频繁或更严重的功能下降。在这个人群中,肺炎与2例患者中几乎1例的功能减退有关.个人入院前的虚弱似乎是功能下降的更重要的预测因子，鼓励对这一人群进行多维护理管理。
