Risk factors analysisi for COVID‑19 in the elderly

ABSTRACT

Objective: To analyze the clinical characteristics and prognosis of the coronavirus disease 2019 (COVID‑19) in the elderly(aged 60 or above), and to explore the high risk factors of severe disease progression for early identification and prevention. Methods: Novel coronavirus pneumonia patients aged 60 or above diagnosed in Hubei Veterans Hospital from January 20 to February 29 in year 2020 were collected. According to the degrees of disease, the patients were divided into mild and severe groups, and their clinical features, laboratory examination, chest CT features, treatment, and outcome were compared. Results: A total of 108 patients were included, including 69 in mild group and 39 in severe group. The average age of the severe group was higher than that of the mild group ( P <0.001). The clinical symptoms of fever, expectoration, dyspnea, fatigue and diarrhea in the severe group were severer and more common than those in the mild group (all P <0.001). The proportion of hypertension ( P <0.05), respiratory system diseases (such as chronic bronchitis and COPD) ( P <0.05), and hypoproteinemia ( P <0.001) combined with COVID⁃19 were higher in severe groupthe severe group. Leukocyte count (WBC), neutrophil count (NEUT), CRP and SAA in the severe group were significantly higher ( P <0.05), while lymphocyte count (LY) and eosinophil count (EOS) were lower than those in the mild group ( P <0.05). Lung CT images showed that patients in the severe group had more bilateral lung involvements and pleural effusion than those in the mild group ( P <0.05). Among the 108 cases, 96 (88.9%) were cured and improved, 12 (11.1%) died. Conclusion: Age, basic comorbidities, decreasing in lymphocytes and acidophilic granulocytes, and multiple bacterial infections are risk factors for severe COVID‑19. Hypoalbuminemia may be a potential and independent adverse prognostic indicator for the elderly COVID‑19. Symptoms of dyspnea and diarrhea, bilateral lung involvements, the pleural effusion are high risk signs for the elderly COVID‑19 patients progressing to severe. These findings are valuable for the early recognition, early diagnosis and treatment for COVID⁃19. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.