Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, China.
Research Unit of Respiratory Disease, Central-South University, Changsha, China.
Gerontology. 2020;66(5):467-475. doi: 10.1159/000508734. Epub 2020 May 29.
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).
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.
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.
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.
本研究旨在分析和总结老年 2019 冠状病毒病（COVID-19）患者的临床特征，并比较年轻老年人（60-74 岁）和老老年人（≥75 岁）的差异。
本回顾性多中心研究纳入了 2020 年 1 月 21 日至 2 月 19 日期间在中国湖南省确诊 COVID-19 的老年患者的病历。比较了年轻老年人和老老年人患者的特征。
105 例确诊 COVID-19 的老年患者中，81.0%为年轻老年人，19.0%为老老年人；54.3%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，22.9%为重症，10.5%为危重症。入院时，老年患者最常见的症状包括发热（66.7%）、咳嗽（64.8%）和乏力（33.3%）。老年 COVID-19 患者常见的实验室异常包括淋巴细胞减少（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 C 反应蛋白升高（79.0%）。老年患者的凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）中位数均长于年轻老年人（PT 中位数 12.3 比 13.1 s，p = 0.007；APTT 中位数 39.0 比 33.5 s，p = 0.045）。年轻老年人的并发症发生率（14.1%）低于老老年人（40.0%；p = 0.0014），接受有创呼吸机支持的比例也较低（3.5%比 25.0%，p = 0.006）。截至 2020 年 3 月 11 日，85.7%的老年患者已出院，3 例死亡，11.4%仍在住院。
老年患者通常患有慢性疾病，且病情可能严重或极重。他们可能出现无发热或咳嗽的不典型症状和多器官功能障碍。住院期间，老老年人比年轻老年人更容易发生并发症。对老年患者进行精心护理、观察和系统治疗非常重要。
