ABSTRACT
ObjectivesTo determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and settingThis is a retrospective, multi-center cohort study performed at twenty-four hospitals in Jiangsu, China. ParticipantsFrom January 10 to March 15, 2020, 625 patients with COVID-19 were involved. ResultsOf the 625 patients (median age, 46 years; 329 [52.6%] males), 37 (5.9%) were children (18 years or less), 261 (40%) young adults (19-44 years), 248 (39.7%) middle-aged adults (45-64 years), and 79 (12.6%) elderly (65 years or more). The incidence of hypertension, coronary heart disease, chronic obstructive pulmonary disease, and diabetes comorbidities increased with age (trend test, P <.0001, P = 0.0003, P <.0001, and P <.0001 respectively). Fever, cough, and shortness of breath occurred more commonly among older patients, especially the elderly, compared to children (Chi-square test, P = 0.0008, 0.0146, and 0.0282, respectively). The quadrant score and pulmonary opacity score increased with age (trend test, both P <.0001). Older patients had significantly more abnormal values in many laboratory parameters than younger patients. Elderly patients contributed the highest proportion of severe or critically-ill cases (33.0%, Chi-square test P < 0.001), intensive care unit (ICU) (35.4%, Chi-square test P < 0.001), and respiratory failure (31.6%, Chi-square test P = 0.0266), and longest hospital stay (21 days, ANOVA-test P < 0.001). ConclusionsElderly ([≥]65) patients with COVID-19 had the highest risk of severe or critical illness, intensive care use, respiratory failure, and the longest hospital stay, which may be due partly to that they had higher incidence of comorbidities and poor immune responses to COVID-19. Strengths and limitations of this studyThe cohort consists of almost all COVID-19 patients in Jiangsu province with a population over 80 million and its results should be representative of the patient population in the whole province and with a wide range of disease severity, therefore the results are subject to less selection bias. The study includes imported and local cases and could study patients with different types of exposures. The relative short follow-up time and a very small proportion of patients who remained in hospital after the 14-day follow-up period yield incomplete estimates for disease severity and clinical outcomes.
