Clinical Characteristics of Elderly Patients with COVID-19 in Hunan Province, China: A Multicenter, Retrospective Study
Clinical Characteristics of Elderly Patients with COVID-19 in Hunan Province, China: A Multicenter, Retrospective Study
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中国湖南省老年 COVID-19 患者的临床特征：一项多中心回顾性研究
DOI：
10.1159/000508734
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发表时间：
2020-09-01
期刊：
影响因子：
3.5
通讯作者：
Peng, Hong
中科院分区：
文献类型：
--
作者：
Guo, Ting;Shen, Qinxue;Peng, Hong
背景：本研究旨在分析总结2019冠状病毒病（COVID-19）老年患者的临床特征，并比较年轻患者（60-74岁）和老年患者（≥75岁）的差异。方法：在这项回顾性、多中心研究中，回顾了 2020 年 1 月 21 日至 2 月 19 日中国湖南省被诊断患有 COVID-19 的老年患者的病历。比较年轻老年患者和老年患者的特征。结果：105例确诊的COVID-19老年患者中，81.0%为年轻患者，19.0%为老年患者； 54.3%的老年患者为女性。总体而言，69.5%的老年患者有基础疾病，最常见的合并症包括高血压（43.8%）、糖尿病（25.7%）和心脏病（16.2%）。老年患者中，重症占22.9%，危重症占10.5%。入院时，老年患者最常见的症状包括发烧（66.7%）、咳嗽（64.8%）和疲劳（33.3%）。老年COVID-19患者常见淋巴细胞减少症（31.4%）、D-二聚体升高（38.1%）、白蛋白降低（36.2%）、乳酸脱氢酶升高（41.0%）和高水平Creactive蛋白（79.0%）。老年患者的中位凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）比年轻患者长（PT中位12.3 vs. 13.1 s，p = 0.007；APTT中位39.0 vs. 33.5 s，p = 0.045）。年轻患者的并发症（14.1%）比老年患者（40.0%；p = 0.0014）更少，接受有创呼吸机支持的患者也更少（3.5% vs. 25.0%，p = 0.006）。截至2020年3月11日，85.7%的老年患者已出院，死亡3例，11.4%仍在住院治疗。结论：老年患者通常患有慢性疾病，并且可能患有重症或危重症。他们可能表现出非典型症状，但没有发烧、咳嗽和多器官功能障碍。高龄患者在住院期间往往比年轻老年患者出现更多并发症。精心护理、观察和系统治疗对于老年患者非常重要。 (C) 2020 S. Karger AG，巴塞尔
Background: The aim of this study was to analyze and summarize the clinical characteristics of elderly patients with coronavirus disease 2019 (COVID-19) and compare the differences of young-old patients (60-74 years old) and old-old patients (>= 75 years old). Methods: In this retrospective, multicenter study, the medical records of elderly patients who were diagnosed with COVID-19 in Hunan province, China, from January 21 to February 19, 2020 were reviewed. The characteristics of young-old patients and old-old patients were compared. Results: Of the 105 elderly patients confirmed with COVID-19, 81.0% were young-old patients, and 19.0% were old-old patients; 54.3% of elderly patients were females. Overall, 69.5% of elderly patients had underlying diseases, and the most common comorbidities included hypertension (43.8%), diabetes (25.7%), and cardiac disease (16.2%). Of the elderly patients, 22.9% were severe and 10.5% were critical severe cases. On admission, the most frequent symptoms in elderly patients included fever (66.7%), cough (64.8%), and fatigue (33.3%). Lymphopenia (31.4%), increased D-dimer (38.1%), depressed albumin (36.2%), elevated lactate dehydrogenase (41.0%), and a high level of Creactive protein (79.0%) were common among elderly patients with COVID-19. The median prothrombin time (PT) and the activated partial thromboplastin time (APTT) were longer in old-old patients than young-old patients (PT median 12.3 vs. 13.1 s, p = 0.007; APTT median 39.0 vs. 33.5 s, p = 0.045). Young-old patients showed fewer complications (14.1%) than old-old patients (40.0%; p = 0.0014) and fewer received invasive ventilator support (3.5 vs. 25.0%, p = 0.006). As of March 11, 2020, 85.7% of elderly patients had been discharged, 3 deaths had occurred, and 11.4% were still hospitalized. Conclusions: Elderly patients usually have chronic medical illness and are likely to have a severe or critically severe condition. They could show atypical symptoms without fever or cough and multiple organ dysfunction. Old-old patients tend to have more complications than young-old patients during hospitalization. Careful nursing, observation, and systemic treatment are very important in elderly patients. (C) 2020 S. Karger AG, Basel