Comparison of clinical characteristics and outcomes of patients with coronavirus disease 2019 at different ages

Abstract

Background: Information about the clinical characteristics and mortality of patients with coronavirus disease 2019 at different ages is limited. Results: The older group had more patients with dyspnea and fewer patients with fever and muscle pain. Older patients had more underlying diseases, secondary infection, myocardial injury, renal dysfunction, coagulation dysfunction, and immune dysfunction on admission. More older patients received immunoglobulin therapy and mechanical ventilation. The proportions of patients with multiple organ injuries, critically ill patients and death increased significantly with age. The older groups had higher cumulative death risk than the younger group. Hypertension, cerebrovascular disease, comorbidities, acute cardiac injury, shock and complications are independent predictors of death. Conclusions: The symptoms of the elderly patients were more atypical, with more comorbidities, secondary infection, organ injuries, immune dysfunction and a higher risk of critical illness. Older age was an important risk factor for mortality. Methods: 1000 patients diagnosed with coronavirus disease 2019 from January 1, 2020 to February 14, 2020 were enrolled. According to age, patients were divided into group 1 (<60 years old), group 2 (60-74 years old) and group 3 (≥75 years old). The clinical symptoms, first laboratory results, CT findings, organ injuries, disease severity and mortality were analyzed. www.aging-us.com 10071 AGING acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still increasing. The numbers of infected patients and deaths both exceeded the respective figures associated with the outbreaks of severe acute respiratory syndrome (SARS) in 2003 [3] and Middle East respiratory syndrome (MERS) in 2015 [4]. Compared to the mortality of SARS (10%) and MERS (35%), COVID-19 has a lower fatality rate of 2.3% [5-7]. However, the rapidly increasing number of cases and increasing evidence of human-to-human transmission suggest that SARS-CoV-2 is more contagious than SARS-CoV and MERS-CoV [8, 9].

Clinical Features of COVID-19 Patients with Different Outcomes in Wuhan: A Retrospective Observational Study

“…A previous study reported findings from 99 patients with COVID-19, and the results suggested that SARS-CoV-2 infection in humans was more likely to affect older men with comorbidities and may result in severe respiratory diseases [ 12 ]. Zhao et al also reported that older patients were more likely to develop critical illness with a significantly higher mortality rate [ 13 ]. Consistent with these studies, in this cohort, we observed a greater number of men than women, and the patients were older in the nonsurviving group than in the surviving group.…”

The Association of Cerebrovascular Disease with Adverse Outcomes in COVID-19 Patients: A Meta-Analysis Based on Adjusted Effect Estimates

“…379 studies were identified after screening titles and abstracts, and 12 studies with 10,304 cases were included conclusively after full-text review. 6 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 Of those, 8 studies reported OR and 4 reported HR, and 8 studies reported the association between cerebrovascular disease and the fatal outcomes. Seven studies came from China, two from America, two from Korea, and one from UK.…”

Características clínicas e efeitos do Covid-19 nos pacientes idosos: uma revisão integrativa

“…Os estudos evidenciaram que a população idosa é mais susceptível à contaminação por COVID-19, bem como à evolução de quadros graves. Além disso, demonstrou-se um amplo espectro clínico da doença nesta população, na qual foi constatada sintomatologia mais agressiva, diversa e relacionada com situações de saúde pré-existentes à infecção 6,7,[9][10][11][12][13] . Observa-se que os idosos apresentam sintomas mais atípicos e com duração ligeiramente mais longa desde o início da sintomatologia até a sua admissão, tornando-se mais difícil a identificação da infecção por COVID-19 de forma precoce.…”

“…Como, por exemplo, o estado mental alterado, demonstrado pelo estudo de Ward 14 , que pode ser um dos primeiros sinais clínicos da infecção por COVID-19 e esse sinal deve ser considerado como um indicativo da doença, possibilitando o tratamento com antecedência, mesmo sem os sintomas respiratórios e febre 14 . Além disso, uma questão que pode explicar a ocorrência de quadros graves é o fato de haver uma propagação da infecção devido à não percepção desses sintomas atípicos, contribuindo para o seu mau prognóstico 11 .…”