Clinical characteristics of 312 hospitalized older patients with COVID-19 in Wuhan, China. (November 2020)

• Record Type: Journal Article
• Authors: Li, Tao; Lu, Lei; Zhang, Weishuo; Tao, Yu; Wang, Liuming; Bao, Jing; Liu, Bao; Duan, Jun
• Is Part Of: Archives of gerontology and geriatrics. Volume 91(2020)
• Publication Date: 2020-11
• Subjects: Clinical characteristics -- Older patients -- COVID-19 -- Severity -- Risk factors -- Outcomes; Aging -- Periodicals; Geriatrics -- Periodicals; Gerontology -- Periodicals; Electronic journals; 305.26
• DOI: 10.1016/j.archger.2020.104185
• Languages: English
• ISSNs: 0167-4943

Abstract

Highlights: Most of the patients with COVID-19 who need to be admitted to hospital are older. Older patients with COVID-19 had much more co-morbidity, complications and mortality. Age, SOFA score, APACHEⅡ score, platelet count＜125 × 109/L, d-dimer, creatinine＞133 μmol/L, interleukin-6, and lung consolidation on admission were independent risk factors for severe cases among older patients with COVID-19. More attention should be paid to older patients with COVID-19. Abstract: Objectives: Much of the previous research on COVID-19 was based on all population. But substantial numbers of severe episodes occur in older patients. There is a lack of data about COVID-19 in older adults. The aims of this study were to analyze the clinical characteristics of older adult patients with COVID-19. Methods: Retrospective study of older patients hospitalized with COVID-19 from February 1 st to March 31 st, 2020 was conducted in the Sino-French New City Branch of Tongjing Hospital in Wuhan, China. According to the degree of severity of COVID-19 during hospitalization, 312 older patients were divided into non-severe and severe cases. Results: the mean age of the patients was 69.2 ± 7.3 years, and 47.4 % of patients had exposure history. 77.2 % of patients had a co-morbidity, with hypertension being the most common (57.1 %), followed by diabetes (38.8 %) and cardiovascular disease (29.8 %). Multivariable regression showed increasing odds of severe COVID-19 associated with age(OR 1.59, 95 %CI 1.13−2.08), SOFA score(OR 5.89, 95 %CI 3.48−7.96), APACHEⅡ score(OR 3.13, 95 %CI 1.85−5.62), platelet count＜125 × 10 9 /L(OR 2.36, 95 %CI 1.03−4.14), d -dimer (OR 4.37, 95 %CI 2.58−7.16), creatinine＞133 μmol/L(OR 1.85, 95 %CI 1.12−3.04), interleukin-6(OR 4.32, 95 %CI 2.07−7.13), and lung consolidation(OR 1.94, 95 %CI 1.45−4.27) on admission. The most common complication was acute respiratory distress syndrome (35.6 %), followed by acute cardiac injury (33.0 %) and coagulation disorders (30.8 %). 91.7 % of patients were prescribed antiviral therapy, followed by immune globulin (52.9 %) and systemic glucocorticoids (43.6 %). 21.8 % of patients received invasive ventilation, 1.92 % for extracorporeal membrane oxygenation. The overall mortality was 6.73 %, and mortality of severe patients was 17.1 %, which was higher than non-severe patients (0.962 %). Conclusions: Older patients with COVID-19 had much more co-morbidity, complications and mortality. More attention should be paid to older patients with COVID-19.