Clinical characteristics of coronavirus disease 2019 in patients aged 80 years and older.
10.1016/j.joim.2020.07.002
- Author:
Jian-Zhong DANG
1
,
2
;
Gang-Yan ZHU
3
;
Ying-Jie YANG
3
;
Fang ZHENG
4
Author Information
1. Department of Geriatrics, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China. Electronic address: dangjianzhong2007@
2. com.
3. Department of Geriatrics, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
4. Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
- Publication Type:Journal Article
- Keywords:
2019-nCoV;
COVID-19;
Coronavirus;
Older patients;
SARS-CoV-2
- MeSH:
Age Factors;
Aged, 80 and over;
Antiviral Agents;
therapeutic use;
China;
epidemiology;
Clinical Laboratory Techniques;
Coronavirus Infections;
diagnosis;
epidemiology;
pathology;
Female;
Humans;
Lung;
diagnostic imaging;
pathology;
Male;
Pandemics;
Pneumonia, Viral;
diagnosis;
epidemiology;
pathology;
Retrospective Studies;
Tomography, X-Ray Computed;
Treatment Outcome
- From:
Journal of Integrative Medicine
2020;18(5):395-400
- CountryChina
- Language:English
-
Abstract:
OBJECTIVE:Coronavirus disease 2019 (COVID-19) has raised concern around the world as an epidemic or pandemic. As data on COVID-19 has grown, it has become clear that older adults have a disproportionately high rate of death from COVID-19. This study describes the early clinical characteristics of COVID-19 in patients with more than 80 years of age.
METHODS:Epidemiological, clinical, laboratory, radiological, and treatment data from 17 patients diagnosed with COVID-19 between January 20 and February 20, 2020 were collected and analyzed retrospectively. Treatment outcomes among subgroups of patients with non-severe and severe symptoms of COVID-19 were compared.
RESULTS:Of the 17 hospitalized patients with COVID-19, the median age was 88.0 years (interquartile range, 86.6-90.0 years; range, 80.0-100.0 years) and 12 (70.6%) were men. The age distribution of patients was not significantly different between non-severe group and severe group. All patients had chronic pre-existing conditions. Hypertension and cardiovascular diseases were the most common chronic conditions in both subgroups. The most common symptoms at the onset of COVID-19 were fever (n = 13; 76.5%), fatigue (n = 11; 64.7%), and cough (n = 5; 29.4%). Lymphopenia was observed in all patients, and lymphopenia was significantly more severe in the severe group than that in non-severe group (0.4 × 10/L vs 1.2 × 10/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group (99.0 μmol/L vs 62.5 μmol/L, P = 0.038). The most common features of chest computed tomography images were nodular foci in 10 (58.8%) patients and pleural thickening in 7 (41.2%) patients. All patients received antiviral therapy, while some patients also received intravenous antibiotics therapy (76.5%), Chinese medicinal preparation therapy (Lianhuaqingwen capsule, 64.7%), corticosteroids (35.3%) or immunoglobin (29.4%). Eight patients (47.1%) were transferred to the intensive care unit because of complications. Ten patients (58.8%) received intranasal oxygen, while 3 (17.6%) received non-invasive mechanical ventilation, and 4 (23.5%) received high-flow oxygen. As of June 20, 7 (41.2%) patients had been discharged and 10 (58.8% of this cohort, 77.8% of severe patients) had died.
CONCLUSION:The mortality of patients aged 80 years and older with severe COVID-19 symptoms was high. Lymphopenia was a characteristic laboratory result in these patients, and the severity of lymphopenia was indicative of the severity of COVID-19. However, the majority of patients with COVID-19 in this age cohort had atypical symptoms, and early diagnosis depends on prompt use of a viral nucleic acid test.
