³ëÀÎ COVID-19 »ç·Ê ÀÓ»óÀû Ư¼º : ³ôÀº ¿°Áõ»óÅ ¹× ³·Àº ¸é¿ª¹æ¾î´É·Â
Understanding the Clinical Features of Coronavirus Disease 2019 From the Perspective of Aging: A Systematic Review and Meta-Analysis
-High Inflammatory State and Low Immune Defense of the Aging Patients With COVID-19-
ÀÓ»óÁú¹® :
³ëÀε鿡°Ô Äڷγª19 °¨¿°ÀÌ ´õ¿í À§Çè°ÍÀº ÀþÀº Ãþ¿¡ ºñÇÏ¿© ³·Àº ¸é¿ª¹æ¾î ´É·ÂÀ̳ª ³ôÀº ¿°Áõ»óÅÂ¿Í °ü·ÃÀÌ ÀÖ½À´Ï±î?
¿¬±¸´äº¯ :
³ëÀÎÃþ ȯÀÚÀÇ Ç÷¾×°Ë»ç°á°ú ÀþÀº Ãþ¿¡ ºñÇÏ¿© ¹éÇ÷±¸ÀÇ ³ôÀº °¡º¯¼ºÀ» ³ªÅ¸³»¾ú´Ù. COVID-19 ³ëÀÎȯÀÚÀÇ ½ÇÇè½Ç °á°ú ³ôÀº ¿°Áõ»óÅ ¹× ³·Àº ¸é¿ª¹æ¾î´É·ÂÀ¸·Î COVID-19 ³ëÀÎ Àα¸¿¡¼ COVID-19·Î ÀÎÇÑ Ãë¾à¼º°ú ºÒ¾ÈÁ¤ÇÑ »óŸ¦ ³ªÅ¸³»¾ú´Ù. Ç÷¾×°Ë»ç °á°ú C- ¹ÝÀÀ¼º ´Ü¹éÁú, ÇÁ·Î Ä®½ÃÅä´Ñ ¹× ÀÎÅÍ·çŲ -6 (C-reactive protein, procalcitonin, and interleukin-6) Åë°è ºÐ¼®À» ¼öÇàÇÏ¿© ³ëÀΠȯÀÚÀÇ ¿°Áõ ¹× ¸é¿ª ¹ÝÀÀÀ» Ãß·ÐÇÏ°í Ç÷¼ÒÆÇ°ú D-dimer¸¦ °è»êÇÏ¿© ³ëÀΠȯÀÚÀÇ ÀÀ°í±â´ÉÀ» È®ÀÎÇÏ¿´´Ù.
³ëÀΠȯÀÚÀÇ ÃÑ ¹éÇ÷±¸¼ö´Â ÀþÀº ȯÀÚº¸´Ù ³ô°Ô ³ªÅ¸³µ´Ù (SMD 0.30, 95 % CI : 0.20–0.39, p <0.01). µ¿½Ã¿¡ ³ëÀΠȯÀÚÀÇ ÃÑ ¹éÇ÷±¸ ¼ö°¡ Áõ°¡ÇÒ À§ÇèÀº û¼Ò³â ±×·ìº¸´Ù ³ô¾Ò´Ù (OR 3.37, 95 % CI : 1.53–7.43, p <0.01). ÇÑÆí, ³ëÀΠȯÀÚ¿¡¼ ¹éÇ÷±¸¼ö°¡ °¨¼Ò ÇÒ À§ÇèÀº µ¿Áú¼ºÀÌ ÀÖ´Â ÀþÀº ±×·ì (OR 0.77, 95 % CI : 0.60–0.98, p = 0.04)º¸´Ù ³ô¾Ò´Ù (I2 = 0 %). ÀÌ·¯ÇÑ º¯È´Â °í·ÉÈ È¯ÀÚ¿¡¼ ¹éÇ÷±¸ÀÇ ³ôÀº °¡º¯¼ºÀ» ³ªÅ¸³»¸ç, ÀÌ´Â ³ëÀÎ Àα¸¿¡¼ COVID-19·Î ÀÎÇÑ Ãë¾à¼º°ú ºÒ¾ÈÁ¤ÇÑ »óŸ¦ ÀǹÌÇÑ´Ù. °á·ÐÀûÀ¸·Î ³ëÀÎ ±×·ìÀº ¸¸¼º ½ÉÇ÷°ü ¹× ½ÅÁø´ë»çµ¿¹Ý Áúȯ À§ÇèÀÌ ³ôÀº °ÍÀ¸·Î ³ªÅ¸³µ´Ù. ¶ÇÇÑ ³ëÀο¬·ÉÀÇ Æ¯Â¡ÀûÀÎ ÀÓ»ó Áõ»ó°ú ½ÇÇè½Ç °Ë»ç°á°ú´Â 2019-nCoV¿¡ ´ëÇÑ °úµµÇÑ ¿°Áõ¹ÝÀÀ°ú ³·Àº ¸é¿ª ¹æ¾î´É·ÂÀ¸·Î ³ªÅ¸³µ´Ù. ÀÌ·¯ÇÑ ¿¬±¸°á°úµéÀº Äڷγª19 ¹ÙÀÌ·¯½º¿¡ ´ëÇÑ ³ëÈ ¸é¿ª ¹æ¾îÀÇ ÀϹÝÀûÀÎ ÀÓ»ó Ư¼ºÀ» ÀÌÇØÇÏ°í COVID-19 À¯Ç༺ ³ëÀΠȯÀÚÀÇ ¿¹¹æ ¹× Ä¡·á¿¡ ´ëÇÑ ´ëÁßÀÇ ÀνÄÀ» ³ôÀÌ´Â µ¥ Áß¿äÇÑ Á¤º¸¸¦ Á¦°øÇÑ´Ù.
°á·ÐÀûÀ¸·Î ³ëÀÎ ±×·ìÀº ¸¸¼º ½ÉÇ÷°ü ¹× ½ÅÁø´ë»çµ¿¹Ý Áúȯ À§ÇèÀÌ ³ôÀº °ÍÀ¸·Î ³ªÅ¸³µ´Ù. ¶ÇÇÑ ³ëÀο¬·ÉÀÇ Æ¯Â¡ÀûÀÎ ÀÓ»ó Áõ»ó°ú ½ÇÇè½Ç °Ë»ç°á°ú´Â 2019-nCoV¿¡ ´ëÇÑ °úµµÇÑ ¿°Áõ¹ÝÀÀ°ú ³·Àº ¸é¿ª ¹æ¾î´É·ÂÀ¸·Î ³ªÅ¸³µ´Ù. º» ¿¬±¸´Â COVID-19 °¨¿°ÀÌ µÈ ´Ù¾çÇÑ ¿¬·É´ëÀÇ È¯ÀÚµéÀÇ ÀÓ»óÀû Ư¡À» Á¾ÇÕÀûÀ¸·Î Æò°¡ÇÏ¿´´Ù. ÃÑ 9,228ÆíÀÇ ³í¹®À» ÃßÃâÇÏ¿© ÃÖÁ¾ºÐ¼®¿¡ Æ÷ÇÔµÈ ´ë»óÀÚ´Â COVID -19 °¨¿°È¯ÀÚ 2,046¸íÀÌ Æ÷ÇԵǾú´Ù. ³ëÀΠȯÀÚ¿¡ ´ëÇÑ ½ÇÇè½Ç °á°ú´Â ³ëÀÎ ±×·ì°ú ÀþÀº±×·ì »çÀÌ¿¡ Å« Â÷À̸¦ ³ªÅ¸³»¾ú´Ù.
¿¬±¸¹æ¹ý
2019³â 1¿ùºÎÅÍ 2020³â 8¿ù 21ÀϱîÁö PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science µ¥ÀÌÅͺ£À̽º¸¦ ÅëÇØ ¿ªÇÐ³í¹®ÀڷḦ Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) ±â¹ÝÀ¸·Î ÃßÃâÇÏ¿´À¸¸ç, À§Çèºñ(RR)°ú 95%½Å·Ú±¸°£À» ÅëÇÕÇÏ¿© ºÐ¼®ÇÏ¿´´Ù.
¿¬±¸°á°ú
ÃÑ 9228ÆíÀÇ ³í¹®Áß¿¡¼ ÃÖÁ¾ºÐ¼®¿¡ Æ÷ÇÔµÈ ´ë»óÀÚ´Â COVID -19 °¨¿°È¯ÀÚ 2,046¸íÀÌ Æ÷ÇÔµÈ 4ÆíÀÇ ¿¬±¸¸¦ ºÐ¼®ÇÏ¿´À¸¸ç ¸ðµÎ Áß±¹ ÈÄÇÑ°ú Èĺ£ÀÌ, Çϳ¿¡¼ ¹ßÇ¥µÈ ³í¹®À̾ú´Ù. ¿¬±¸°á°ú ³ëÀÎ ±×·ìÀÌ ÀþÀº ȯÀÚº¸´Ù °íÇ÷¾Ð, ´ç´¢º´, ½ÉÇ÷°ü ÁúȯÀÇ À§ÇèÀÌ ´õ ³ôÀº °ÍÀ¸·Î ³ªÅ¸³µÀ¸¸ç, ³ëÀÎÃþÀÇ ÃÑ ¹éÇ÷±¸´Â ÀþÀº ȯÀÚº¸´Ù ³ôÀ¸¸ç ¸²ÇÁ±¸´Â ÀþÀº ȯÀÚ¿¡ ºñÇØ »ó´ëÀûÀ¸·Î °¨¼ÒÇÏ¿´´Ù.
º» ¿¬±¸´Â COVID-19 °¨¿°ÀÌ µÈ ´Ù¾çÇÑ ¿¬·É´ëÀÇ È¯ÀÚµéÀÇ ÀÓ»óÀû Ư¡À» Á¾ÇÕÀûÀ¸·Î Æò°¡ÇÏ¿´´Ù. ÃÑ 9228ÆíÀÇ ³í¹® Áß¿¡¼ ÃÖÁ¾ºÐ¼®¿¡ Æ÷ÇÔµÈ ´ë»óÀÚ´Â COVID -19 °¨¿°È¯ÀÚ 2,046¸íÀÌ Æ÷ÇԵǾú´Ù. ³ëÀΠȯÀÚ¿¡ ´ëÇÑ ½ÇÇè½Ç °á°ú´Â ³ëÀÎ ±×·ì°ú ÀþÀº±×·ì »çÀÌ¿¡ Å« Â÷À̸¦ ³ªÅ¸³»¾ú´Ù.
Ç¥ 1) COVID-19 Áø´ÜÀ» ¹ÞÀº ³ëÀÎȯÀÚÀÇ Ç÷¾×°Ë»ç °á°ú
(Source: Understanding the Clinical Features of Coronavirus Disease 2019 From the Perspective of Aging: A Systematic Review and Meta-Analysis. 2020 Nov 11. doi: 10.3389/fendo.2020.557333)
Ç÷¾×°Ë»ç °á°ú C- ¹ÝÀÀ¼º ´Ü¹éÁú, ÇÁ·Î Ä®½ÃÅä´Ñ ¹× ÀÎÅÍ·çŲ -6 (C-reactive protein, procalcitonin, and interleukin-6) Åë°è ºÐ¼®À» ¼öÇàÇÏ¿© ³ëÀΠȯÀÚÀÇ ¿°Áõ ¹× ¸é¿ª ¹ÝÀÀÀ» Ãß·ÐÇÏ°í Ç÷¼ÒÆÇ°ú D-dimer¸¦ °è»êÇÏ¿© ³ëÀΠȯÀÚÀÇ ÀÀ°í±â´ÉÀ» È®ÀÎÇÏ¿´´Ù. ³ëÀΠȯÀÚÀÇ ÃÑ ¹éÇ÷±¸¼ö´Â ÀþÀº ȯÀÚº¸´Ù ³ô°Ô ³ªÅ¸³µ´Ù (SMD 0.30, 95 % CI : 0.20–0.39, p <0.01). µ¿½Ã¿¡ ³ëÀΠȯÀÚÀÇ ÃÑ ¹éÇ÷±¸ ¼ö°¡ Áõ°¡ÇÒ À§ÇèÀº û¼Ò³â ±×·ìº¸´Ù ³ô¾Ò´Ù (OR 3.37, 95 % CI : 1.53–7.43, p <0.01). ÇÑÆí, ³ëÀΠȯÀÚ¿¡¼ ¹éÇ÷±¸¼ö°¡ °¨¼Ò ÇÒ À§ÇèÀº µ¿Áú¼ºÀÌ ÀÖ´Â ÀþÀº ±×·ì (OR 0.77, 95 % CI : 0.60–0.98, p = 0.04)º¸´Ù ³ô¾Ò´Ù (I2 = 0 %). ÀÌ·¯ÇÑ º¯È´Â °í·ÉÈ È¯ÀÚ¿¡¼ ¹éÇ÷±¸ÀÇ ³ôÀº °¡º¯¼ºÀ» ³ªÅ¸³»¸ç, ÀÌ´Â ³ëÀÎ Àα¸¿¡¼ COVID-19·Î ÀÎÇÑ Ãë¾à¼º°ú ºÒ¾ÈÁ¤ÇÑ »óŸ¦ ÀǹÌÇÑ´Ù.
°á·ÐÀûÀ¸·Î ³ëÀÎ ±×·ìÀº ¸¸¼º ½ÉÇ÷°ü ¹× ½ÅÁø´ë»çµ¿¹Ý Áúȯ À§ÇèÀÌ ³ôÀº °ÍÀ¸·Î ³ªÅ¸³µ´Ù. ¶ÇÇÑ ³ëÀο¬·ÉÀÇ Æ¯Â¡ÀûÀÎ ÀÓ»ó Áõ»ó°ú ½ÇÇè½Ç °Ë»ç°á°ú´Â 2019-nCoV¿¡ ´ëÇÑ °úµµÇÑ ¿°Áõ¹ÝÀÀ°ú ³·Àº ¸é¿ª ¹æ¾î´É·ÂÀ¸·Î ³ªÅ¸³µ´Ù. ÀÌ·¯ÇÑ ¿¬±¸°á°úµéÀº ½ÅÁ¾ Äڷγª ¹ÙÀÌ·¯½º (2019-nCov) °¨¿°ÀÌ ÇöÀç Àü¼¼°èÀûÀ¸·Î ´ëÀ¯ÇàÀ¸·Î ³Î¸® ÆÛÁ®ÀÖ´Â »óÅ¿¡¼ COVID-19¿¡ ´ëÇÑ ³ëÈ ¸é¿ª ¹æ¾îÀÇ ÀϹÝÀûÀÎ ÀÓ»ó Ư¼ºÀ» ÀÌÇØÇÏ°í COVID-19 À¯Ç༺ ³ëÀΠȯÀÚÀÇ ¿¹¹æ ¹× Ä¡·á¿¡ ´ëÇÑ ´ëÁßÀÇ ÀνÄÀ» ³ôÀÌ´Â µ¥ Áß¿äÇÑ Á¤º¸¸¦ Á¦°øÇϱâ À§ÇÔÀÌ´Ù.
ÀÇ°úÇבּ¸Á¤º¸¼¾ÅÍ Á¦°ø
Reference
Understanding the Clinical Features of Coronavirus Disease 2019 From the Perspective of Aging: A Systematic Review and Meta-Analysis (2020). 2020 Nov 11;11:557333. doi: 10.3389/fendo.2020.557333.