COVID-19'lu Yaşlı Hastalarda Komorbidite, Laboratuvar Bulguları ve Klinik Sonuçların Değerlendirilmesi

Öz

Amaç: Bu çalışmada COVID-19 ile enfekte yaşlı hastaların altta yatan hastalıklarını, laboratuvar bulgularını ve klinik sonuçlarını analiz etmeyi amaçladık. Ayrıca yaşlı hastalarda kritik vakaların ve mortalitenin tahmininde laboratuar parametrelerinin değerini araştırdık. Materyal ve Metod: Çalışmaya COVID-19 teşhisi konan 60 yaş ve üzeri 314 yaşlı hasta dahil edildi. Çalışmaya dahil edilen hastalar yaşa göre genç yaşlı hasta (60-74 yaş) ve ileri yaşlı hasta (≥75 yaş ) olmak üzere ikiye ayrıldı. Katılımcıların yaşı, cinsiyeti, altta yatan hastalıkları, laboratuar bulguları hastalık şiddeti ve sağ kalım verileri hastane kayıtlarında elde edildi. Bulgular: Yaşlı COVID-19 vakalarında en sık görülen komorbiditeler sırasıyla hipertansiyon (%57.6), diabetes mellitus (%33.8) ve kardiyovasküler hastalık (%28) idi. İleri yaşlı hastalarda, genç yaşlı hastalara kıyasla kritik tip (%63.4 vs %30.8, P<0.001) ve ölüm (%41.9 vs %21.3, P<0.001) oranları daha yüksekti. İleri yaşlı grubun lökosit sayısı, nötrofil sayısı, üre, kreatinin, C-reaktif protein (CRP), prokalsitonin, ferritin, troponin T, kreatin kinaz-MB, protrombin zamanı ve D-dimer değerleri genç yaşlı gruba göre daha yüksekti. Tam tersine, hemoglobin ve albümin değerleri ileri yaşlı grupta daha düşüktü. Kritik olan yaşlı COVID-19 hastalarını tahmin etmede albümin, CRP, prokalsitonin, ferritin, protrombin zamanı ve troponin T’nin ROC eğrisi altında kalan alanları (AUCs) 0.800'den büyüktü. Ferritin, ölümü öngörmede en yüksek AUC değerine sahipti (AUC: 0.819), ardından CRP (AUC: 0.805) ve prokalsitonin (AUC: 0.796) gelmekte idi. Sonuç: İleri yaşlı hastalarda, genç yaşlı hastalara kıyasla hastalığın kritik tipini ve ölüm oranlarını daha yüksek bulduk. Ayrıca, ferritin, CRP ve prokalsitonin COVID-19 ile enfekte yaşlı bireylerde hem hastalık şiddetini hem de mortaliteyi öngörmede güçlü göstergeler idi.

Anahtar Kelimeler

• COVID-19
• Yaşlı Hastalar
• Klinik sonuçlar
• Hastalık şiddeti
• Laboratuvar parametreleri

Evaluation of Comorbidities, Laboratory Findings and Clinical Outcomes in Elderly Patients with COVID-19

Öz

Background: In this study, we aimed to analyze the underlying diseases, laboratory findings and clinical outcomes of elderly patients infected with COVID-19. We also investigated the value of laboratory parameters in the estimation of critical cases and mortality in elderly patients. Materials and Methods: The study included 314 elderly patients aged 60 years and older who were diagnosed with COVID-19.The patients were divided into two groups according to age, as young old patients (60-74 years) and old old patients (≥75 years). Participants' age, gender, underlying diseases, laboratory findings, disease severity and survival data were obtained from hospital records. Results: The most common comorbidities in elderly patients were hypertension (57.6%), diabetes mellitus (33.8%) and cardiovascular disease (28%). Old old patients had higher rates of critical type (63.4% vs 30.8%, P<0.001) and death (41.9% vs 21.3%, P<0.001) compared to young old patients. The leukocyte count, neutrophil count, urea, creatinine, C-reactive protein (CRP), procalcitonin, ferritin, troponin T, creatine kinase-MB, prothrombin time and D-dimer values were higher in the old old group compared to the young old group. In contrast, hemoglobin and albumin values were lower in the old old group. The areas under the curve (AUC) of albumin, CRP, procalcitonin, ferritin, troponin T and prothrombin time were greater than 0.80 to predict critically elderly COVID-19 patients. Ferritin had the highest AUC for predicting death (AUC: 0.819) followed by CRP (AUC: 0.805) and procalcitonin (AUC: 0.796). Conclusions: We found higher rates of critical type and death in old old patients compared to young old patients. In addition, ferritin, CRP, and procalcitonin were strong predictors of both disease severity and mortality in COVID-19-infected elderly subjects.

Anahtar Kelimeler

• COVID-19
• Elderly patients
• Clinical outcomes
• Disease severity
• Laboratory parameters

Kaynakça

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