Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China (2019): a single-centered, retrospective study

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Abstract

Background

In December 2019, the coronavirus disease 2019 (COVID-19) emerged in Wuhan city and spread rapidly throughout China and the world. In this study, we aimed to describe the clinical course and outcomes of older patients with COVID-19.

Methods

This is a retrospective investigation of hospitalized older patients with confirmed COVID-19 at Zhongnan Hospital of Wuhan University from January 1, 2020, to February 10, 2020.

Results

In total, 203 patients were diagnosed with COVID-19, with a median age of 54 years (interquartile range, 41-68; range, 20-91 years). Men accounted for 108 (53.2%) of the cases, and 55 patients (27.1%) were >65 years of age. Among patients who were 65 years and older, the mortality rate was 34.5% (19/55), which was significantly higher than that of younger patients at 4.7% (7/148). Common symptoms of older patients with COVID-19 included fever (94.5%; n=52), dry cough (69.1%; n=38), and chest distress (63.6%; n=35). Compared with young patients, older patients had more laboratory abnormalities and comorbidities. Through a multivariate analysis of the causes of death in older patients, we found that males, comorbidities, time from disease onset to hospitalization, abnormal kidney function, and elevated procalcitonin levels were all significantly associated with death.

Conclusions

In the recent outbreak of COVID-19, our local hospital in Wuhan found that patients aged 65 and older had greater initial comorbidities, more severe symptoms, and were more likely to experience multi-organ involvement and death, as compared with younger patients.

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Most cited references 1

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Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications

K.H. Kim, T.E. Tandi, J.W. Choi … (2016)

Summary Background Since the first case of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea was reported on 20th May 2015, there have been 186 confirmed cases, 38 deaths and 16,752 suspected cases. Previously published research on South Korea's MERS outbreak was limited to the early stages, when few data were available. Now that the outbreak has ended, albeit unofficially, a more comprehensive review is appropriate. Methods Data were obtained through the MERS portal by the Ministry for Health and Welfare (MOHW) and Korea Centres for Disease Control and Prevention, press releases by MOHW, and reports by the MERS Policy Committee of the Korean Medical Association. Cases were analysed for general characteristics, exposure source, timeline and infection generation. Sex, age and underlying diseases were analysed for the 38 deaths. Findings Beginning with the index case that infected 28 others, an in-depth analysis was conducted. The average age was 55 years, which was a little higher than the global average of 50 years. As in most other countries, more men than women were affected. The case fatality rate was 19.9%, which was lower than the global rate of 38.7% and the rate in Saudi Arabia (36.5%). In total, 184 patients were infected nosocomially and there were no community-acquired infections. The main underlying diseases were respiratory diseases, cancer and hypertension. The main contributors to the outbreak were late diagnosis, quarantine failure of ‘super spreaders’, familial care-giving and visiting, non-disclosure by patients, poor communication by the South Korean Government, inadequate hospital infection management, and ‘doctor shopping’. The outbreak was entirely nosocomial, and was largely attributable to infection management and policy failures, rather than biomedical factors.

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Author and article information

Journal

Journal ID (nlm-ta): J Gerontol A Biol Sci Med Sci

Journal ID (iso-abbrev): J. Gerontol. A Biol. Sci. Med. Sci

Journal ID (publisher-id): gerona

Title: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences

Publisher: Oxford University Press (US )

ISSN (Print): 1079-5006

ISSN (Electronic): 1758-535X

Publication date (Electronic): 11 April 2020

Publication date PMC-release: 11 April 2020

Electronic Location Identifier: glaa089

Affiliations

[1 ] Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China

[2 ] Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China

[3 ] Department of Infectious Diseases, Shanghai Fifth People’s Hospital of Fudan University, Shanghai, China

Author notes

Corresponding author: Liping Deng, MD, Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China. Phone: 0086 27 67813076, E-mail: dengdeng78@ 123456126.com

These authors contributed equally to this work.

Author information

Liping Deng http://orcid.org/0000-0002-7651-0096

Article

Publisher ID: glaa089

DOI: 10.1093/gerona/glaa089

PMC ID: 7184388

PubMed ID: 32279081

SO-VID: e57b7493-dadd-4251-b92b-df4713a4cb21

Copyright © © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

History

Date received : 11 March 2020

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ScienceOpen disciplines: Geriatric medicine

Keywords: covid-19,sars-cov-2,coronavirus,wuhan,older patients,clinical characteristics

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ScienceOpen disciplines: Geriatric medicine

Keywords: covid-19, sars-cov-2, coronavirus, wuhan, older patients, clinical characteristics