Analysis of Epidemiological and Clinical Features in Older Patients With Coronavirus Disease 2019 (COVID-19) Outside Wuhan

Abstract

Background. The outbreak of coronavirus disease 2019 has become a large threat to public health in China, with high contagious capacity and varied mortality. This study aimed to investigate the epidemiological and clinical characteristics of older patients with COVID-19 outside Wuhan.Methods. A retrospective study was performed, with collecting data from medical records of confirmed COVID-19 patients in Zhejiang province from 17 January to 12 February 2020. Epidemiological, clinical, and treatment data were analyzed between older (≥ 60 years) and younger (< 60 years) patients.Results. A total of 788 patients with confirmed COVID-19 were selected; 136 were older patients with corresponding mean age of 68.28 ± 7.31 years. There was a significantly higher frequency of women in older patient group compared with younger patients (57.35% vs 46.47%, P = .021). The presence of coexisting medical conditions was significantly higher in older patients compared with younger patients (55.15% vs 21.93%, P < .001), including the rate of hypertension, diabetes, heart disease, and chronic obstructive pulmonary disease. Significantly higher rates of severe clinical type (older vs younger groups: 16.18% vs 5.98%, P < .001), critical clinical type (8.82% vs 0.77%, P < .001), shortness of breath (12.50% vs 3.07%, P < .001), and temperature of > 39.0°C (13.97% vs 7.21%, P = .010) were observed in older patients compared with younger patients. Finally, higher rates of intensive care unit admission (9.56% vs 1.38%, P < .001) and methylprednisolone application (28.68% vs 9.36%, P < .001) were also identified in older patients compared with younger ones.Conclusions. The specific epidemiological and clinical features of older COVID-19 patients included significantly higher female sex, body temperature, comorbidities, and rate of severe and critical type disease.

COVID-19 in older adults: clinical, psychosocial, and public health considerations

“…Sex differences in outcomes may be attenuated among older adults. In a cohort of 788 patients from Zhejiang Province, China, there was a higher frequency of women among infected patients 60 years or older versus those younger than 60 years (57.4% vs. 46.5%, P = 0.021) (8).…”

“…(12% for patients >60 years vs. 3% for patients <60 years) (8). Although 89% of patients experienced a fever (defined as a temperature greater than 99.5°F) during their hospitalization in one study, only 44% were febrile at the time of admission (9).…”

“…Common laboratory abnormalities include lymphopenia and thrombocytopenia (5). Higher rates of lymphopenia and anemia, lower albumin, and higher aspartate transaminase (AST) and C-reactive protein (CRP) are found in older adults compared with younger patients (8). Chest computed tomography (CT) is more sensitive than chest x-ray for detection of pulmonary disease.…”

“…The median time from the development of first symptoms to dyspnea was 5 days and time to hospital admission was 7 days (9). Symptomatic older adults are more likely to require ICU admission (9.6% vs. 1.4%, P < 0.001) and develop acute respiratory distress syndrome (ARDS) (16.9% vs. 5.4%, P < 0.001) compared with patients less than 60 years of age (8). Incidence of concomitant thromboembolism is high among critically ill COVID-19 patients (13).…”

Clinical features and management of severe COVID-19: A retrospective study in Wuxi, Jiangsu Province, China

“…The severity of COVID-19 was defined according to the Chinese management guideline (7th edition). The severe-type patients were characterized by dyspnea, respiratory frequency ≥ 30/minute, blood oxygen saturation ≤ 93%, PaO 2 /FiO 2 ratio <300, and/or lung infiltrates >50% within 24-48 hours [9,11]. Clustered epidemic was defined as at least two confirmed cases or asymptomatic infections were found within a small area (e.g.…”