Ting Guo1,2,3, Qinxue Shen1,2,3, Wei Guo1,2,3, Wenlong He1,2,3, Jinhua Li1,2,3, Yi Zhang1,2,3, Yunnian Wang4, Zhiguo Zhou5, Dingding Deng6, Xiaoli Ouyang1,2,3, Zhi Xiang7, Minyan Jiang8, Minyong Liang9, Peng Huang10, Zaimei Peng11, Xudong Xiang11, Wenlong Liu12, Hong Luo1,2,3, Ping Chen1,2,3, Hong Peng13,14,15. 1. Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, China. 2. Research Unit of Respiratory Disease, Central-South University, Changsha, China. 3. The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, China. 4. Department of Respiratory and Critical Care Medicine, The Traditional Chinese Medicine Hospital of Liling, Zhuzhou, China. 5. Department of Respiratory and Critical Care Medicine, The First Hospital of Changsha, Changsha, China. 6. Department of Respiratory and Critical Care Medicine, The First Hospital of Shaoyang University, Shaoyang, China. 7. Department of Respiratory and Critical Care Medicine, The First People's Hospital of Huaihua, Huaihua, China. 8. Department of Respiratory and Critical Care Medicine, The Central Hospital of Xiangtan, Xiangtan, China. 9. Department of Respiratory and Critical Care Medicine, The People's Hospital of Xiangxi Autonomous Prefecture, Xiangxi, China. 10. Department of Respiratory and Critical Care Medicine, The Central Hospital of Zhuzhou, Zhuzhou, China. 11. Department of Emergency, The Second Xiangya Hospital of Central-South University, Changsha, China. 12. Department of Respiratory and Critical Care Medicine, The Junshan People's Hospital of Yueyang, Yueyang, China. 13. Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, China, penghong66@csu.edu.cn. 14. Research Unit of Respiratory Disease, Central-South University, Changsha, China, penghong66@csu.edu.cn. 15. The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, China, penghong66@csu.edu.cn.
Abstract
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 thisretrospective, 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 patientsconfirmed withCOVID-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 C-reactive 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.
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 thisretrospective, 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 patientsconfirmed withCOVID-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 C-reactive 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.
Authors: Gerard Thomas Flaherty; Paul Hession; Chee Hwui Liew; Bryan Chang Wei Lim; Tan Kok Leong; Victor Lim; Lokman Hakim Sulaiman Journal: Trop Dis Travel Med Vaccines Date: 2020-08-28
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