Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2022; 10(35): 12890-12898
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12890
Clinical features of elderly patients with COVID-19 in Wuhan, China
Shuo Wei, Guang Chen, Xiao-Chun Ouyang, Yuan-Cheng Hong, Yun-Hu Pan
Shuo Wei, Department of Infectious Disease, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350000, Fujian Province, China
Guang Chen, Yun-Hu Pan, Department of Respiratory Medicine, 907 Hospital of the Joint Logistics Team, Nanping 353000, Fujian Province, China
Guang Chen, Xiao-Chun Ouyang, Yuan-Cheng Hong, Yun-Hu Pan, No. 4 Infection Department Second Ward, Wuhan Huoshenshan Hospital, Wuhan 430010, Hubei Province, China
Xiao-Chun Ouyang, Department of Respiratory Medicine, 908 Hospital of the Joint Logistics Team, Nanchang 330038, Jiangxi Province, China
Yuan-Cheng Hong, Department of Respiratory Medicine, 910 Hospital of the Joint Logistics Team, Quanzhou 362046, Fujian Province, China
Author contributions: Pan YH and Wei S conceived the structure of the manuscript and wrote the manuscript; Chen G contributed to data collection; Ouyang XC and Hong YC had roles in clinical management; all authors revised the manuscript and approved the final manuscript.
Supported by the Key Research Project of Nanjing Military Area Command, No. 14ZD32; Nanping Natural Science Foundation, No. 2019J32; and Natural Science Foundation of Fujian Province, No. 2021J01377.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Fujian Provincial Hospital Institutional Review Board (Approval No. K2020-03-044).
Conflict-of-interest statement: The authors have declared that no competing interest exists.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Hu Pan, MD, Associate Chief Physician, Department of Respiratory Medicine, 907 Hospital of the Joint Logistics Team, No. 99 Binjiang North Road, Nanping 353000, Fujian Province, China. 18750975908@163.com
Received: July 1, 2022
Peer-review started: July 1, 2022
First decision: September 5, 2022
Revised: September 13, 2022
Accepted: November 17, 2022
Article in press: November 17, 2022
Published online: December 16, 2022
Processing time: 165 Days and 18.1 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with coronavirus disease 2019 (COVID-19) can present with a wide range of symptoms and different degrees of severity. Although most patients are asymptomatic or have mild disease, some patients develop a severe form of the disease. Previous studies showed that disease severity was correlated with several risk characteristics, such as older age. In view of this, we analyzed the clinical characteristics of elderly patients from Wuhan who had COVID-19 during the early stages of the pandemic.

Research motivation

To evaluate the factors affecting early mortality of elderly patients with COVID-19 in Wuhan, China.

Research objectives

To identify factors affecting the mortality of elderly patients with COVID-19 within 1 mo after admission.

Research methods

The records of 234 COVID-19 patients who were 65-years-old or more and were hospitalized in Wuhan Huoshenshan Hospital from February 4 to March 4, 2020 were reviewed.

Research results

There were 163 cases of mild disease, 39 cases of severe disease, and 32 cases of critical disease. Twenty-nine patients died within 1 month, all of whom had critical disease. The survivors and deceased had no significant differences in age or chronic diseases. Fever, dry cough, fatigue and shortness of breath were the most common symptoms. Elevated levels of multiple disease markers (C-reactive protein, D-dimer, lactate dehydrogenase, alanine amino transferase, aspartate aminotransferase, creatinine kinase and creatinine kinase-MB) and the prevalence of lymphocytopenia and hypoproteinemia were more common in the deceased patients.

Research conclusions

Our study of elderly patients who were hospitalized with COVID-19 indicated that age and chronic disease were not associated with mortality. Hypertension, diabetes and cardiovascular disease were the most common comorbidities, and the most common symptoms were fever, dry cough, fatigue and shortness of breath. Lymphocytopenia and increased levels of D-dimer and other markers were indicative of damage to the heart, kidneys or liver and were associated with an increased risk of death.

Research perspectives

We speculate that weak immune responses of elderly patients may not increase their risk for excessive inflammation during the early onset of COVID-19. However, as the disease progresses, organ dysfunction and other complications increase the risk of mortality.