Background: The COVID-19 pandemic poses tremendous threats to the world. Elderly patients are among the high-risk population, and apt to experience worse outcomes.
Methods: Elderly patients (age ≥60 years old) were enrolled from January 28 to February 29, 2020, in Tongji Hospital, one of designated COVID-19 medical centers in Wuhan, China.
A retrospective study was performed to describe clinical characteristics, laboratory findings, chest imaging, treatment, and outcomes of elderly COVID-19 patients. COX regression was used to analyze predictors for 28-day mortality. Linear regression models were constructed to analyze factors associated with length of hospital stay (LOS).
RESULT: A total of 186 elderly patients (aged 70.4 ± 7.1 years, 95 males (51.6%)) were enrolled, 120 patients (64.5%) were severe or critical type, and mortality rate was 16.1% (30/186). Of 156 survived patients, 150 were discharged. Fever (83.3%), cough (80.6%) and dyspnea (68.3%) were the most frequent symptoms. Common comorbidities included hypertension (48.9%) and diabetes (32.8%). Ground-glass opacities (97.3%) and peripheral distribution (59.1%) were the most predominant patterns on chest imaging. Patients in non-survival group had a higher smoking rate, more symptoms of dyspnea, lab results indicative of poorer health, and needed more medications or supportive treatment. Age (HR 1.128, 95% CI 1.066-1.194), lymphocyte count (HR 0.261, 95% CI 0.073-0.930), LDH (HR 1.003, 95% CI 1.002-1.005), procalcitonin (HR 1.061, 95% CI 1.002-1.125), and qSOFA (HR 3.162, 95% CI 1.646-6.072) were predictors of independently associated with 28-day mortalitydeath. CURB-65 plus LDH on admission were strong predictors of death by ROC analysis (AUROC=0.891). Among surviving patients, consolidation on CTs (β=8.611), elevated ferritin level (β=0.004) and neutrophil count (β=0.806) were associated with increased LOS.
Conclusion: High incidence of comorbidities and mortality were observed in elderly patients. Decreased lymphocyte, older age, higher qSOFA score, procalcitonin and LDH levels were associated with 28-day mortalityindependent factors associated with death, and CURB-65 plus LDH could bewere a strong predictive model of deathfatal outcome. Consolidation on CTs, elevated ferritin and neutrophil level correlated with increased LOS. Further prospective studies should be performed to test our findings and for explore potential treatments.