Clinical characteristics of 312 hospitalized older patients with COVID-19 in Wuhan, China
Clinical characteristics of 312 hospitalized older patients with COVID-19 in Wuhan, China
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DOI：
10.1016/j.archger.2020.104185
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发表时间：
2020-11-01
影响因子：
4
通讯作者：
Duan, Jun
中科院分区：
文献类型：
--
作者：
Li, Tao;Lu, Lei;Duan, Jun
目的：之前关于COVID-19的大部分研究都是基于所有人群的。但大量严重发作发生在老年患者中。缺乏关于老年人COVID-19的数据。本研究的目的是分析老年COVID-19患者的临床特征。方法：对2020年2月1日至3月31日在中国武汉通经医院中法新城分院住院的老年COVID-19患者进行回顾性研究。根据住院期间COVID-19的严重程度，将312例老年患者分为非重症和重症。结果：患者平均年龄69.2±7.3岁，有暴露史的占47.4%。77.2%的患者有合并症，其中高血压最常见（57.1%），其次是糖尿病（38.8%）和心血管疾病（29.8%）。多变量回归显示发生几率增加与年龄相关的严重COVID-19(或1.59,95%可信区间1.13 - 2.08),沙发分数(或5.89,95%可信区间3.48 - 7.96),APACHEII评分(或3.13,95%可信区间1.85 - 5.62),血小板计数< 125 x 10 (9) / L(或2.36,95%可信区间1.03 - 4.14),肺动脉栓塞(或4.37,95%可信区间2.58 - 7.16),肌酐> 133亩mol / L(或1.85,95%可信区间1.12 - 3.04)、白细胞介素- 6(或4.32,95%可信区间2.07 - 7.13),和肺部合并(或1.94,95%可信区间1.45 - 4.27)录取。最常见的并发症是急性呼吸窘迫综合征（35.6%），其次是急性心脏损伤（33.0%）和凝血功能障碍（30.8%）。91.7%的患者接受抗病毒治疗，其次是免疫球蛋白（52.9%）和全身糖皮质激素（43.6%）。21.8%的患者接受有创通气，1.92%的患者接受体外膜氧合。总病死率为6.73%，重症患者病死率为17.1%，高于非重症患者（0.962%）。结论：老年COVID-19患者的合并症、并发症和死亡率明显高于老年患者。老年新冠肺炎患者应受到更多关注。
Objectives: Much of the previous research on COVID-19 was based on all population. But substantial numbers of severe episodes occur in older patients. There is a lack of data about COVID-19 in older adults. The aims of this study were to analyze the clinical characteristics of older adult patients with COVID-19.Methods: Retrospective study of older patients hospitalized with COVID-19 from February 1 st to March 31 st, 2020 was conducted in the Sino-French New City Branch of Tongjing Hospital in Wuhan, China. According to the degree of severity of COVID-19 during hospitalization, 312 older patients were divided into non-severe and severe cases.Results: the mean age of the patients was 69.2 +/- 7.3 years, and 47.4 % of patients had exposure history. 77.2 % of patients had a co-morbidity, with hypertension being the most common (57.1 %), followed by diabetes (38.8 %) and cardiovascular disease (29.8 %). Multivariable regression showed increasing odds of severe COVID-19 associated with age(OR 1.59, 95 %CI 1.13 - 2.08), SOFA score(OR 5.89, 95 %CI 3.48 - 7.96), APACHEII score (OR 3.13, 95 %CI 1.85 - 5.62), platelet count < 125 x 10(9) /L(OR 2.36, 95 %CI 1.03 - 4.14), D-dimer (OR 4.37, 95 %CI 2.58 - 7.16), creatinine > 133 mu mol/L(OR 1.85, 95 %CI 1.12 - 3.04), interleukin-6(OR 4.32, 95 %CI 2.07 - 7.13), and lung consolidation(OR 1.94, 95 %CI 1.45 - 4.27) on admission. The most common complication was acute respiratory distress syndrome (35.6 %), followed by acute cardiac injury (33.0 %) and coagulation disorders (30.8 %). 91.7 % of patients were prescribed antiviral therapy, followed by immune globulin (52.9 %) and systemic glucocorticoids (43.6 %). 21.8 % of patients received invasive ventilation, 1.92 % for extracorporeal membrane oxygenation. The overall mortality was 6.73 %, and mortality of severe patients was 17.1 %, which was higher than non-severe patients (0.962 %).Conclusions: Older patients with COVID-19 had much more co-morbidity, complications and mortality. More attention should be paid to older patients with COVID-19.