Clinical Characteristics of 312 Hospitalized Older Patients with COVID-19 in Wuhan, China

Li, Tao; Lu, Lei; Zhang, Weishuo; Tao, Yu; Wang, Liuming; Bao, Jing; Liu, Bao; Duan, Jun

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.