Comparison of clinical characteristics and outcomes of patients with coronavirus disease 2019 at different ages

Abstract

Background: Information about the clinical characteristics and mortality of patients with coronavirus disease 2019 at different ages is limited.

Results: The older group had more patients with dyspnea and fewer patients with fever and muscle pain. Older patients had more underlying diseases, secondary infection, myocardial injury, renal dysfunction, coagulation dysfunction, and immune dysfunction on admission. More older patients received immunoglobulin therapy and mechanical ventilation. The proportions of patients with multiple organ injuries, critically ill patients and death increased significantly with age. The older groups had higher cumulative death risk than the younger group. Hypertension, cerebrovascular disease, comorbidities, acute cardiac injury, shock and complications are independent predictors of death.

Conclusions: The symptoms of the elderly patients were more atypical, with more comorbidities, secondary infection, organ injuries, immune dysfunction and a higher risk of critical illness. Older age was an important risk factor for mortality.

Methods: 1000 patients diagnosed with coronavirus disease 2019 from January 1, 2020 to February 14, 2020 were enrolled. According to age, patients were divided into group 1 (<60 years old), group 2 (60-74 years old) and group 3 (≥75 years old). The clinical symptoms, first laboratory results, CT findings, organ injuries, disease severity and mortality were analyzed.

Keywords: 2019 novel coronavirus; COVID-19; age; clinical characteristics; coronavirus disease 2019; prognosis.

Figure 1

Comparison of the time-dependent risk of death. (A) The cumulative death risk after admission in age group 1 (blue curve), age group 2 (red curve) and age group 3 (green curve). Compared to age group 1, the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of age groups 2 and 3 were HR: 1.944 (1.156-3.271; P <0.05) and HR: 4.777 (2.850- 8.008; P <0.001), respectively. The model was adjusted for sex and comorbidities. (B) The cumulative death risk after disease onset in age group 1 (blue curve), age group 2 (red curve) and age group 3 (green curve). Compared to age group 1, the HRs (95% CIs) of age groups 2 and 3 were HR: 1.849 (1.1-3.108; P <0.05) and HR: 4.77 (2.841-8.008; P <0.001). The model was adjusted for sex and comorbidities.

Figure 2

Predictors of the death in the proportional hazards model. (A) Shown in the figure are the hazards ratio (HR) and the 95% confidence interval (95%CI) for the risk factors of death after disease onset. The comorbidities were classified according to the organ systems as well as the number. (B), Shown in the figure are the hazards ratio (HR) and the 95% confidence interval (95%CI) for the risk factors of death after disease onset. The complications were classified according to the organ systems as well as the number. * means the P value <0.05. The scale bar indicates the HR. The model has been adjusted with age groups.