Background
Methods
Patients
Data collection
Statistical analysis
Results
Demographic characteristics among 3 groups
Younger (n = 102) | Middle-aged (n = 157) | Older (n = 307) | |
---|---|---|---|
Age (years) | 37.0 (32.0–41.3) | 54.0 (49.5–57.0) | 69.0 (65.0–76.0) |
Sex | |||
Male | 54 (52.9%) | 60 (38.2%) | 153 (49.8%) |
Female | 48 (47.1%) | 97 (61.8%) | 154 (50.2%) |
Typical symptoms | |||
Fever | 71 (69.6%) | 126 (80.3%) | 248 (80.8%) |
Dry cough | 63 (61.8%) | 108 (68.8%) | 183 (59.6%) |
Fatigue | 38 (37.3%) | 76 (48.4%) | 144 (46.9%) |
Dyspnea | 12 (11.8%) | 26 (16.6%) | 41 (13.4%) |
Neurological symptoms | |||
Dizziness | 3/102 (2.9%) | 9/156 (5.8%) | 16/302 (5.3%) |
Headache | 5/102 (4.9%) | 13/156 (8.3%) | 10/302 (3.3%) |
Impaired consciousness | 0 (0.0%) | 0 (0.0%) | 3 (1.0%) |
Comorbidity | |||
Any | 18 (17.6%) | 66 (42.0%)* | 222 (72.3%)*# |
Hypertension | 6 (5.9%) | 52 (33.1%)* | 158 (51.5%)*# |
Diabetes | 3 (2.9%) | 19 (12.1%)* | 52 (16.9%)* |
CAD | 0 (0.0%) | 8 (5.1%) | 50 (16.3%)*# |
Cerebral infarction | 0 (0.0%) | 1 (0.6%) | 21 (6.8%)* |
Cancer | 1 (1.0%) | 2 (1.3%) | 9 (2.9%) |
CKD | 2 (2.0%) | 1 (0.6%) | 7 (2.3%) |
COPD | 0 (0.0%) | 1 (0.6%) | 7 (2.3%) |
SBP (mmHg) | 122.0 (116.0–130.0) | 129.0 (120.0–140.0)* | 134.0 (121.0–148.0)*# |
DBP (mmHg) | 78.0 (70.0–85.0) | 80.0 (70.0–87.5) | 80.0 (70.0–87.0) |
Heart rate (bpm) | 85.0 (76.0–98.0) | 86.0 (77.5–96.0) | 85.0 (77.0–98.0) |
Laboratory findings among 3 groups
Younger (n = 102) | Middle-aged (n = 157) | Older (n = 307) | |
---|---|---|---|
White blood cells (109/L) | 5.57 (4.16–7.18) | 5.37 (4.28–7.07) | 5.73 (4.53–7.56) |
Neutrophils (109/L) | 2.93 (2.11–4.66) | 3.14 (2.55–4.59) | 3.87 (2.73–5.56)*# |
Lymphocytes (109/L) | 1.52 (1.09–2.02) | 1.31 (0.90–1.73) | 1.01 (0.68–1.57)*# |
< 0.8 | 13 (12.7%) | 29 (18.5%) | 101 (32.9%)*# |
Hemoglobin (g/L) | 133.0 (122.8–145.0) | 125.0 (116.5–135.5)* | 121.0 (111.0–132.0)*# |
Platelet (109/L) | 220.5 (177.3–272.3) | 231.0 (178.0–295.5) | 208.0 (155.0–261.0)# |
< 100 | 0 (0.0%) | 2 (1.3%) | 19 (6.2%)*# |
CRP (mg/L) | 2.53 (0.50–11.88) | 5.60 (0.71–37.40) | 27.70 (2.64–72.85)*# |
ALT (U/L) | 26.0 (17.8–48.0) | 27.0 (18.0–51.0) | 23.0 (16.0–36.0)# |
AST (U/L) | 23.0 (17.0–33.3) | 25.0 (19.0–37.0) | 27.0 (19.0–39.0)* |
ALP (U/L) | 57.0 (45.0–69.3) | 64.5 (52.0–81.3)* | 66.0 (55.0–81.0)* |
GGT (U/L) | 23.0 (15.0–39.3) | 29.5 (18.0–51.0) | 27.0 (17.0–47.0) |
Total bilirubin (μmol/L) | 10.1 (7.2–13.0) | 10.2 (7.5–13.7) | 11.1 (8.4–15.2)*# |
Albumin (g/L) | 41.5 (38.4–44.7) | 39.4 (36.6–42.1)* | 36.6 (33.1–39.3)*# |
< 30 | 0 (0.0%) | 0 (0.0%) | 18 (5.9%)*# |
Urea nitrogen (mmol/L) | 4.11 (3.10–5.42) | 4.53 (3.40–5.61) | 5.40 (4.28–7.41)*# |
Creatinine (μmol/L) | 61.0 (48.8–72.0) | 55.0 (46.5–67.5) | 63.0 (52.0–75.0)# |
Blood glucose (mmol/L) | 4.99 (4.59–5.87) | 5.36 (4.83–6.76)* | 5.80 (5.04–7.43)*# |
Creatine kinase (U/L) | 61.0 (44.0–108.0) | 56.0 (35.0–82.5) | 60.0 (42.0–94.5) |
LDH (U/L) | 189.0 (164.8–298.5) | 227.0 (187.0–281.0) | 265.0 (210.0–363.0)*# |
CK-MB (ng/mL) | 0.64 (0.44–0.88) | 0.75 (0.54–1.05) | 1.27 (0.90–2.25)*# |
cTnI (ng/mL) | 0.006 (0.006–0.006) | 0.006 (0.006–0.006) | 0.008 (0.006–0.025)*# |
Complications | |||
ARDS | 15 (14.7%) | 35 (22.3%) | 88 (28.7%)* |
Acute cardiac injury | 4/91 (4.4%) | 5/154 (3.2%) | 66/306 (21.6%)*# |
With history of cardiovascular disease | 0/5 (0.0%) | 0/53 (0.0%) | 56/178 (31.5%)# |
Without history of cardiovascular disease | 4/86 (4.7%) | 5/101 (5.0%) | 10/128 (7.8%) |
Heart failure (elevated BNP) | 1/72 (1.4%) | 5/132 (3.8%) | 39/269 (14.5%)*# |
Novel or worsening arrhythmia | 21 (20.6%) | 26 (16.6%) | 71 (23.1%) |
Acute liver injury | 9 (8.8%) | 11 (7.0%) | 35 (11.4%) |
Acute kidney injury | 2 (2.0%) | 1 (0.6%) | 13 (4.2%) |
Skeletal muscle injury | 9/102 (8.8%) | 8/150 (5.3%) | 20/285 (7.0%) |
Treatment | |||
Antiviral therapy | 97 (95.1%) | 150 (95.5%) | 295 (96.1%) |
Antibiotic therapy | 66 (64.7%) | 114 (72.6%) | 230 (74.9%) |
Glucocorticoids | 27 (26.5%) | 42 (26.8%) | 127 (41.4%)*# |
Oxygen support | |||
Nasal cannula | 71 (69.6%) | 111 (70.7%) | 220 (71.7%) |
Non-invasive ventilation (ie, face mask) | 9 (8.8%) | 25 (15.9%) | 65 (21.2%)* |
Invasive mechanical ventilation | 1 (1.0%) | 4 (2.5%) | 12 (3.9%) |
Severe | 49 (48.0%) | 99 (63.1%)* | 254 (82.7%)*# |
Clinical outcome | |||
Discharge | 100 (98.0%) | 150 (95.5%) | 250 (81.4%)*# |
Death | 2 (2.0%) | 7 (4.5%) | 57 (18.6%)*# |
The subgroup analysis of older patients
Younger old (n = 216) | Oldest-old (n = 91) | P | |
---|---|---|---|
Age (years) | 66.0 (63.0–69.0) | 79.0 (76.0–82.0) | < 0.001 |
Male | 96 (44.4%) | 57 (62.6%) | 0.004 |
Comorbidity | |||
Any | 143 (66.2%) | 79 (86.8%) | < 0.001 |
Hypertension | 96 (44.4%) | 62 (68.1%) | < 0.001 |
Diabetes | 37 (17.1%) | 15 (16.5%) | 0.890 |
CAD | 27 (12.5%) | 23 (25.3%) | 0.006 |
Cerebral infarction | 8 (3.7%) | 13 (14.3%) | 0.001 |
Cancer | 6 (2.8%) | 3 (3.3%) | 1.000 |
CKD | 3 (1.4%) | 4 (4.4%) | 0.233 |
COPD | 3 (1.4%) | 4 (4.4%) | 0.233 |
Laboratory findings | |||
White blood cells (109/L) | 5.72 (4.34–7.39) | 5.96 (4.74–8.12) | 0.155 |
Neutrophils (109/L) | 3.70 (2.54–5.47) | 4.30 (3.37–6.54) | 0.006 |
Lymphocytes (109/L) | 1.18 (0.73–1.68) | 0.85 (0.59–1.29) | < 0.001 |
< 0.8 | 58 (26.9%) | 43 (47.3%) | 0.001 |
Hemoglobin (g/L) | 121.0 (112.0–131.0) | 121.0 (109.0–133.0) | 0.660 |
Platelet (109/L) | 213.0 (165.3–269.5) | 197.0 (134.0–242.0) | 0.011 |
< 100 | 10 (4.6%) | 9 (9.9%) | 0.081 |
CRP (mg/L) | 18.90 (1.37–73.09) | 53.55 (12.28–73.03) | 0.001 |
ALT (U/L) | 24.0 (16.0–35.8) | 23.0 (16.0–39.0) | 0.829 |
AST (U/L) | 25.0 (18.0–35.8) | 30.0 (21.0–48.0) | 0.002 |
Albumin (g/L) | 37.1 (33.6–40.0) | 35.0 (32.0–37.7) | < 0.001 |
< 30 | 11 (5.1%) | 7 (7.7%) | 0.376 |
Urea nitrogen (mmol/L) | 5.10 (4.00–6.51) | 7.70 (4.80–11.31) | < 0.001 |
Creatinine (μmol/L) | 60.0 (50.0–70.0) | 68.0 (57.0–100.0) | < 0.001 |
Blood glucose (mmol/L) | 5.80 (5.06–7.74) | 5.79 (4.90–7.01) | 0.658 |
Creatine kinase (U/L) | 59.0 (42.0–86.5) | 62.0 (42.5–150.0) | 0.103 |
LDH (U/L) | 252.0 (200.0–346.0) | 289.0 (230.0–452.0) | 0.001 |
CK-MB (ng/mL) | 1.12 (0.83–1.63) | 2.27 (1.32–4.43) | < 0.001 |
cTnI (ng/mL) | 0.006 (0.006–0.014) | 0.027 (0.010–0.193) | < 0.001 |
Complications | |||
ARDS | 56 (25.9%) | 32 (35.2%) | 0.102 |
Acute cardiac injury | 23/215 (10.7%) | 43/91 (47.3%) | < 0.001 |
With history of cardiovascular disease | 19/108 (17.6%) | 37/70 (52.9%) | < 0.001 |
Without history of cardiovascular disease | 4/107 (3.7%) | 6/21 (28.6%) | 0.001 |
Heart failure (elevated BNP) | 21/185 (11.4%) | 18/84 (21.4%) | 0.030 |
New or worsening arrhythmia | 54 (25.0%) | 17 (18.7%) | 0.230 |
Acute liver injury | 20 (9.3%) | 15 (16.5%) | 0.069 |
Acute kidney injury | 4 (1.9%) | 9 (9.9%) | 0.004 |
Skeletal muscle injury | 9/204 (4.4%) | 11/81 (13.6%) | 0.006 |
Clinical outcome | |||
Discharge | 191 (88.4%) | 59 (64.8%) | < 0.001 |
Death | 25 (11.6%) | 32 (35.2%) |
The predictors for the prognosis of elderly patients
Univariate | Multivariate | |||
---|---|---|---|---|
OR (95%CI) | P | OR (95%CI) | P | |
Age (years) | 1.111 (1.069–1.155) | 0.000 | 1.085 (1.017–1.158) | 0.014 |
History of cardiovascular disease | 3.299 (1.665–6.535) | 0.001 | ||
ARDS | 8.888 (4.687–16.853) | 0.000 | 8.576 (3.084–23.850) | 0.000 |
Acute cardiac injury | 22.960 (11.284–46.717) | 0.000 | 3.690 (1.233–11.042) | 0.020 |
Heart failure | 9.583 (4.552–20.178) | 0.000 | 4.782 (1.543–14.817) | 0.007 |
New or worsening arrhythmia | 1.384 (0.722–2.652) | 0.328 | ||
Acute liver injury | 1.915 (0.862–4.253) | 0.111 | ||
Acute kidney injury | 4.084 (1.317–12.661) | 0.015 | ||
Skeletal muscle injury | 10.545 (4.013–27.709) | 0.000 | 7.330 (1.453–36.977) | 0.016 |
Leukocytosis | 10.635 (4.897–23.094) | 0.000 | ||
Lymphopenia | 4.435 (2.427–8.105) | 0.000 | 2.793 (1.030–7.578) | 0.044 |
Hypoalbuminemia | 3.042 (1.124–8.231) | 0.028 | ||
Antiviral therapy | 1.146 (0.244–5.378) | 0.863 | ||
Antibiotic therapy | 7.714 (2.338–25.450) | 0.001 | ||
Glucocorticoids | 3.989 (2.155–7.384) | 0.000 | 3.990 (1.364–11.668) | 0.011 |