新型冠状病毒肺炎老年患者的临床及影像特征分析

Analysis of clinical and imaging features of elderly patients with COVID-19 elderly patients

目的:探讨不同年龄组新型冠状病毒肺炎(COVID-19)患者的临床及影像学表现。方法:回顾性分析蚌埠医学院第一附属医院2020年2月-3月期间治愈或死亡出院的79例COVID-19患者的临床及影像学资料,将所有患者分为两组:老年组年龄≥60岁及非老年组年龄<60岁,比较两组的首诊临床分型、首诊时间、住院时间、有无基础疾病史、各种常见临床表现、化验室指标及出、入院时CT图像中病灶的位置、数目、范围、累及肺段等表现的相关性。结果:79例COVID-19患者中,老年组患者28例、非老年组患者51例。临床上以发热、咳嗽、乏力为主要表现。老年组中75.0%患者伴有基础疾病,而非老年组中仅有31.4%患者伴有基础疾病,两者差异有统计学意义(P<0.05);老年组中有15例(占53.6%)入院时表现为重型,非老年组中仅12例(占23.5%)入院时表现为重型,两者差异有统计学意义(P<0.05)。老年组COVID-19患者从出现症状到就诊入院时间更长[(12.54±7.71)d和(9.24±4.67)d,P<0.05],其CRP升高者也显著多于非老年患者(96.2%和77.3%,P<0.05)。两组患者入院时CT的各种表现包括病灶分布、数目、累及肺段及病灶密度等方面差异均无统计学意义(P>0.05)。出院时CT表现中,老年COVID-19患者病灶累及肺段更多[(10.07±5.11)个和(7.78±4.66)个,P<0.05];而在病灶分布、数目及密度方面两组差异无统计学意义(P>0.05)。结论:COVID-19患者中,与患者年龄关系密切的临床及影像学因素包括首诊临床分型、首诊时间、CRP、有无基础疾病及出院时病灶累及肺段。

Objective:To explore the clinical and imaging manifestations of COVID-19 patients in different age groups.Methods:The clinical and imaging data of 79 COVID-19 patients in the First Affiliated Hospital of Bengbu Medical College,who were cured or died and discharged d from the first affiliated Hospital of Bengbu Medical Collegeor died from February to March 2020,were analyzed retrospectively.All patients were divided into two groups:The age of the elderly group≥60 years old and the age of the non-elderly group<60 years old.The correlation between the two groups in the clinical classification was compared,including of the first diagnosis,the time of the first diagnosis,the time of hospitalization,the history of basic diseases,various common clinical manifestations,laboratory indexes and the location,number,range of the lesions in the CT images of the admission and the pulmonary segments involved.were compared.Results:Among the 79 COVID-19 patients,28 were in the elderly group and 51 in the non-elderly group.The main clinical manifestations arewere fever,cough and fatigue.In the elderly group,75.0%patients had basic diseases,while only 31.4%patients in the non-elderly group had basic diseases,the difference was statistically significant(P<0.05).In the elderly group,15 patients(53.6%)showed severe symptoms on admission,while in the non-elderly group,only 12 patients(23.5%)showed severe symptoms on admission,the difference was statistically significant(P<0.05).In the elderly group,the time from symptom to admission was longer(12.54±7.71 d and 9.24±4.67 d,P<0.05),and the proportion of increased CRP was higher(96.2%and 77.3%,P<0.05).There was no significant difference between the two groups in various manifestations of CT,including the distribution,number of lesions,the involvement of lung segments and the density of lesions(P>0.05).At the time of discharge,there were more lesions involving lung segments in elderly COVID-19 patients(10.07±5.11 and 7.78±4.66,P<0.05),but there was no statistical significance in the distribution,number and density of lesions in the two groups(P>0.05).Conclusions:In patients with COVID-19,the clinical and imaging factors closely related to the age of the patients,includinge the clinical classification of the first visit,the time of the first visit,CRP,the presence or absence of underlying diseases and the involved lung segments at discharge.