Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12890
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
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.
To evaluate the factors affecting early mortality of elderly patients with COVID-19 in Wuhan, China.
To identify factors affecting the mortality of elderly patients with COVID-19 within 1 mo after admission.
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.
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.
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.
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.