ABSTRACT
Background: The clinical and paraclinical symptoms of COVID-19 differ across age groups. This study investigated the differences between these parameters and their outcomes in young, middle-aged, and elderly patients admitted to a COVID-19 referral center. Materials and Methods: This retrospective study encompassed patients with COVID-19 hospitalized at Khorshid Hospital (Isfahan, Iran) during February 23 to April 30, 2020. The patients' predisposing conditions, clinical and paraclinical findings, and outcomes were compared among three young, middle-aged, and elderly groups. Results: Of the 1185 hospitalized patients with suspected COVID-19, 1065 were discharged or died at the end of the study. Among these 1065 patients, 654 patients with the mean age of 57.7 years had positive PCR results or typical CT scans and were included in the study, of whom 77 (11.8%), 353 (54%), and 234 (34.2%) patients were assigned into the young, middle-aged, and elderly groups, respectively. There was no statistically significant difference among the three groups regarding the prevalence of clinical symptoms. Moreover, CRP, ESR, WBC, BUN, Cr, and lymphocytes were higher in the elderly group. The ground-glass opacity (GGO) (24.1%), GGO-consolidation (27.4%), and consolidation (10.3%) were the most common CT scan findings in the young, middle-aged, and elderly groups, respectively. Fifty-three patients (8.1%) died, and the mortality rates were 10.36%, 7.27%, and 3.8% in the elderly, middle-aged, and young groups, respectively. Conclusion: COVID 19 symptoms do not depend on age;however, paraclinical findings differ across young, middle-aged, and elderly patients.
ABSTRACT
Introduction: In severe COVID-19 patients, a pre-inflamatory condition leads to a cytokine storm syndrome. This may signify the need for using immunomodulatory drugs. Patients with rheumatic diseases (RDs) are prone to severe infectious diseases. Objectives: Whether the presence of the RD itself or the use of its drugs in patients with COVID-19 increases the severity of symptoms and outcomes remains largely unknown. Patients and Methods: In a prospective cohort study conducted in Khorshid hospital of Isfahan, Iran, 219 patients with COVID-19 were enrolled and divided into two groups of patients with a positive history for RD (n=19) and those without this history (NRD, n=200). The severity of symptoms and outcomes was compared between the groups. Results: Shortness of breath (P = 0.001), cough (P = 0.019), and weakness (P = 0.001) were significantly higher in the RD than the NRD group after, but not before, recovery. All the patients in the RD group had comorbid diseases (hypertension, diabetes mellitus, ischemic heart disease, and cerebrovascular disease), the number of which was significantly higher than that of the NRD group (P < 0.001). The Charlson Comorbidity Index (CCI) was used to predict 10-year survival in patients with multiple comorbidities. It was significantly lower in the RD group as opposed to the NRD group (P < 0.001). Logistic regression also showed a non-significantly higher chance of the composite outcome (ICU admission, death status, and intubation status) in the RD group as opposed to the NRD group, both before and after adjustment for confounding factors. However, no difference was found between the RD patient who received corticosteroid as a treatment (RD-CS) and those who did not (RD-NCS). Conclusion: The results showed an increased risk for severe forms of COVID-19 in RD patients. This risk is possibly attributable to a high prevalence of comorbidities in these patients.