Effects of Comorbidities on the Elderly Patients with COVID-19: Clinical Characteristics of Elderly Patients Infected with COVID-19 from Sichuan, China

被引:21
作者
Dai, S. -P. [1 ]
Zhao, X. [2 ]
Wu, J-H [1 ]
机构
[1] Sichuan Univ, Natl Ctr Geriatr Clin Med Res, Dept Geriatr & Gerontol, West China Hosp, Chengdu 610041, Peoples R China
[2] Publ Hlth Clin Ctr Chengdu, ICU 2, Chengdu, Peoples R China
关键词
COVID-19; comorbidities; elderly; clinical characteristics; Sichuan Province; DISEASE; HEALTH;
D O I
10.1007/s12603-020-1486-1
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives The co-occurrence of chronic diseases in the elderly is a common problem. However, the relationship between comorbidities and the prognosis of elderly patients with COVID-19 was not clear. This study was supposed to describe the clinical characteristics of elderly patients with COVID-19 infection from Sichuan province and the effects of comorbidity. Design A retrospective study. Settings and participants COVID-19 patients from Public Health Clinical Center of Chengdu between December 16, 2019 and February 26, 2020 were included in this study. Patients were divided into elderly group (>= 60 years old) and non-elderly group (< 60 years old). Results Elderly patients with COVID-19 indicated relatively higher proportion of comorbidities, and the most common were atherosclerotic cardiovascular disease (56.5%), hypertension (43.5%) and chronic pulmonary disease (21.7%). The proportion of severe cases was higher in elderly group than that in non-elderly group (73.9% and 42.2%, respectively, P=0.012). During hospitalization, elderly patients indicated relatively higher proportion of complications, such as shock (21.7%), respiratory failure (21.7%). The proportion of patients with a decreased number of CD8+ lymphocytes (82.6%) and B lymphocytes (77.8%) in elderly patients was significantly higher than that in non-elderly group (48.9% and 44.8%, respectively). All 3 deaths were elderly patients with comorbidities and the cell counts of T lymphocyte subsets, B and NK cells of them were significantly decreased at admission. Conclusions Elderly patients with COVID-19 had a high proportion of severe cases and comorbidities, more likely to show low immune function, and indicate higher proportion of complications.
引用
收藏
页码:18 / 24
页数:7
相关论文
共 26 条
[1]   Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020 [J].
Backer, Jantien A. ;
Klinkenberg, Don ;
Wallinga, Jacco .
EUROSURVEILLANCE, 2020, 25 (05) :10-15
[2]   Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design? [J].
Boyd, Cynthia M. ;
Fortin, Martin .
PUBLIC HEALTH REVIEWS, 2010, 32 (02) :451-474
[3]   A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster [J].
Chan, Jasper Fuk-Woo ;
Yuan, Shuofeng ;
Kok, Kin-Hang ;
To, Kelvin Kai-Wang ;
Chu, Hin ;
Yang, Jin ;
Xing, Fanfan ;
Liu, Jieling ;
Yip, Cyril Chik-Yan ;
Poon, Rosana Wing-Shan ;
Tsoi, Hoi-Wah ;
Lo, Simon Kam-Fai ;
Chan, Kwok-Hung ;
Poon, Vincent Kwok-Man ;
Chan, Wan-Mui ;
Ip, Jonathan Daniel ;
Cai, Jian-Piao ;
Cheng, Vincent Chi-Chung ;
Chen, Honglin ;
Hui, Christopher Kim-Ming ;
Yuen, Kwok-Yung .
LANCET, 2020, 395 (10223) :514-523
[4]   T cell-mediated immune response to respiratory coronaviruses [J].
Channappanavar, Rudragouda ;
Zhao, Jincun ;
Perlman, Stanley S. .
IMMUNOLOGIC RESEARCH, 2014, 59 (1-3) :118-128
[5]  
Chen N, 2020, LANCET, V39S, pS07
[6]   Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease [J].
Coventry, Peter ;
Lovell, Karina ;
Dickens, Chris ;
Bower, Peter ;
Chew-Graham, Carolyn ;
McElvenny, Damien ;
Hann, Mark ;
Cherrington, Andrea ;
Garrett, Charlotte ;
Gibbons, Chris J. ;
Baguley, Clare ;
Roughley, Kate ;
Adeyemi, Isabel ;
Reeves, David ;
Waheed, Waquas ;
Gask, Linda .
BMJ-BRITISH MEDICAL JOURNAL, 2015, 350 :1-11
[7]  
Deng SQ, 2020, CHARACTERISTICS PUBL, V9, DOI [10.3390/jcm9020S7S, DOI 10.3390/JCM9020S7S]
[8]  
Guan WJ, 2020, NEW ENGL J MED, V382, P1861, DOI 10.1056/NEJMc2005203
[9]   Guiding Principles for the Care of Older Adults with Multimorbidity: An Approach for Clinicians [J].
Ickowicz, Elvy .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2012, 60 (10) :E1-E25
[10]   Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model [J].
Kingston, Andrew ;
Robinson, Louise ;
Booth, Heather ;
Knapp, Martin ;
Jagger, Carol .
AGE AND AGEING, 2018, 47 (03) :374-380