Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
BMJ Open. 2020 Oct 5;10(10):e039887. doi: 10.1136/bmjopen-2020-039887.
To determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China.
Retrospective, multicentre cohort study performed at 24 hospitals in Jiangsu, China.
625 patients with COVID-19 enrolled between 10 January and 15 March 2020.
Of the 625 patients (median age, 46 years; 329 (52.6%) men), 37 (5.9%) were children (18 years or younger), 261 (41.8%) young adults (19-44 years), 248 (39.7%) middle-aged adults (45-64 years) and 79 (12.6%) elderly adults (65 years or older). The incidence of hypertension, coronary heart disease, chronic obstructive pulmonary disease and diabetes comorbidities increased with age (trend test, p<0.0001, p=0.0003, p<0.0001 and p<0.0001, respectively). Fever, cough and shortness of breath occurred more commonly among older patients, especially the elderly, compared with children (χ test, p0.0008, 0.0146 and 0.0282, respectively). The quadrant score and pulmonary opacity score increased with age (trend test, both p<0.0001). Older patients had many significantly different laboratory parameters from younger patients. Elderly patients had the highest proportion of severe or critically-ill cases (33.0%, χ test p<0.0001), intensive care unit use (35.4%, χ test p<0.0001), respiratory failure (31.6%, χ test p<0.0001) and the longest hospital stay (median 21 days, Kruskal-Wallis test p<0.0001).
Elderly (≥65 years) patients with COVID-19 had the highest risk of severe or critical illness, intensive care use, respiratory failure and the longest hospital stay, which may be due partly to their having a higher incidence of comorbidities and poor immune responses to COVID-19.
在中国江苏确定 COVID-19 患者的特定年龄临床表现和不良结局发生率。
在中国江苏的 24 家医院进行的回顾性、多中心队列研究。
2020 年 1 月 10 日至 3 月 15 日期间纳入的 625 例 COVID-19 患者。
在 625 例患者中（中位年龄 46 岁；329 例（52.6%）为男性），37 例（5.9%）为儿童（18 岁或以下），261 例（41.8%）为青年（19-44 岁），248 例（39.7%）为中年（45-64 岁）和 79 例（12.6%）为老年（65 岁或以上）。高血压、冠心病、慢性阻塞性肺疾病和糖尿病合并症的发生率随年龄增长而增加（趋势检验，p<0.0001，p=0.0003，p<0.0001 和 p<0.0001，分别）。与儿童相比，发热、咳嗽和呼吸急促在年龄较大的患者中更为常见，尤其是在老年人中（卡方检验，p<0.0008、0.0146 和 0.0282，分别）。象限评分和肺不透明度评分随年龄增加而增加（趋势检验，均 p<0.0001）。老年患者与年轻患者的实验室参数有许多显著差异。老年患者的严重或危重症病例比例最高（33.0%，卡方检验 p<0.0001），使用重症监护病房（35.4%，卡方检验 p<0.0001），呼吸衰竭（31.6%，卡方检验 p<0.0001）和最长住院时间（中位数 21 天，Kruskal-Wallis 检验 p<0.0001）。
年龄≥65 岁的 COVID-19 患者有发生严重或危重症、需要重症监护、呼吸衰竭和住院时间最长的最高风险，这可能部分归因于他们合并症发生率较高，以及对 COVID-19 的免疫反应较差。
