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...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(0.4×10~9/L vs 1.2×10~9/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group(99.0 lmol/L vs 62.5 lmol/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.展开更多
基金supported by grant from the National Nature Sciences Foundation of China (No. 81500639)。
文摘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(0.4×10~9/L vs 1.2×10~9/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group(99.0 lmol/L vs 62.5 lmol/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.
