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Published on: December 19, 2020
Clinical characteristics and manifestations in older patients with COVID-19
Chenchen Wei1, Ya Liu2, Yapeng Liu1
1The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
Insights
Older adults, particularly the oldest-old, face severe COVID-19 outcomes including organ damage and higher mortality. Key predictors of death in this group include age, lymphopenia, acute respiratory distress syndrome, and cardiac injury.
Area of Science:
- Gerontology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) disproportionately affects older adults.
- Understanding the specific clinical profiles of elderly COVID-19 patients is crucial for targeted interventions.
Purpose of the Study:
- To investigate the clinical characteristics, manifestations, and outcomes of older patients diagnosed with COVID-19.
- To identify risk factors associated with mortality in elderly COVID-19 patients.
Main Methods:
- A retrospective study analyzing data from 566 confirmed COVID-19 patients.
- Collection and analysis of clinical characteristics, laboratory findings, complications, and outcome data.
Main Results:
- Older patients (≥60 years) exhibited more comorbidities and laboratory abnormalities compared to younger groups.
- Higher rates of acute respiratory distress syndrome (ARDS), acute cardiac injury, and heart failure were observed in older patients.
- Mortality was significantly higher in older patients (18.6%) compared to younger and middle-aged groups.
Conclusions:
- Older adults, especially the oldest-old, are at increased risk for severe systemic inflammation, multi-organ damage, and mortality from COVID-19.
- Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure, and skeletal muscle injury are independent predictors of death in older COVID-19 patients.
- Glucocorticoid use requires careful consideration in elderly COVID-19 patients due to potential harm.
Background:
To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19).
Methods:
In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed.
Results:
Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients presented more severe with the mortality of 18.6%, which was higher than that in younger and middle-aged patients (P < 0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with death in older patients, while glucocorticoids might be harmful.
Conclusions:
Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients with COVID-19 and glucocorticoids should be carefully administered in older patients.
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