ABSTRACT

Shanghai has been experiencing the Omicron wave since March 2022. Though several studies have evaluated the risk factors of severe infections, the analyses of BA.2 infection risk and protective factors among geriatric people were much limited. This multicentre cohort study described clinical characteristics, and assessed risk and protective factors for geriatric Omicron severe infections. A total of 1377 patients older than 60 were enrolled, with 75.96% having comorbidities. The median viral shedding time and hospitalization time were nine and eight days, respectively. Severe and critical were associated with longer virus clearance time (aOR [95%CI]:0.706 (0.533–0.935), P = .015), while fully vaccinated/booster and paxlovid use shortened viral shedding time (1.229 [1.076–1.402], P = .002; 1.140 [0.019–1.274], P = .022, respectively). Older age (>80), cerebrovascular disease, and chronic kidney disease were risk factors of severe/critical. Fully vaccination was a significant protective factor against severe infections (0.237 [0.071–0.793], P = .019). We found patients with more than two comorbidities were more likely to get serious outcomes. These findings demonstrated that in the elderly older than 60 years old, older age (aged over 80), cerebrovascular disease, and chronic kidney disease were risk factors for severe infection. Patients with more than two comorbidities were more likely to get serious outcomes. Fully vaccinated/booster patients were less likely to be severe and vaccinations could shorten viral shedding time. The limitation of lacking an overall spectrum of COVID-19 infections among elders could be compensated in other larger-scale studies in the future.

 抽象的

上海自2022年3月以来一直在经历Omicron浪潮。尽管有多项研究评估了严重感染的危险因素，但对老年人群中BA.2感染风险和保护因素的分析非常有限。这项多中心队列研究描述了老年 Omicron 严重感染的临床特征，并评估了风险和保护因素。共有 1377 名 60 岁以上患者入组，其中 75.96% 患有合并症。中位病毒排出时间和住院时间分别为九天和八天。严重和危重与较长的病毒清除时间相关（aOR [95%CI]:0.706 (0.533–0.935), P = .015），而完全疫苗/加强疫苗和帕克洛维德的使用缩短了病毒排出时间（1.229 [1.076–1.402] ， P = .002；分别为 1.140 [0.019–1.274]， P = .022）。年龄较大（>80）、脑血管疾病、慢性肾脏病是重症/危重症的危险因素。充分接种疫苗是预防严重感染的重要保护因素（0.237 [0.071–0.793]， P = .019）。我们发现患有两种以上合并症的患者更有可能出现严重的后果。这些发现表明，在60岁以上老年人中，年龄较大（80岁以上）、脑血管疾病、慢性肾脏病是严重感染的危险因素。患有两种以上合并症的患者更有可能出现严重的后果。完全接种疫苗/加强免疫的患者病情严重的可能性较小，并且疫苗接种可以缩短病毒排出时间。缺乏老年人中 COVID-19 感染总体谱的局限性可以在未来的其他更大规模的研究中得到补偿。