不同程度老年新型冠状病毒肺炎住院患者的临床特征比较分析

Comparison and analysis of clinical characteristics in hospitalized elderly COVID-19 patients of varying severity

目的分析不同程度老年新型冠状病毒肺炎(COVID-19)住院患者的临床特征,提高对其认识和救治的能力。方法收集2020年2月至4月新型冠状病毒肺炎住院患者有完整临床资料的70例,分析流行病学史、基础疾病、临床表现特征和治疗以及转归。将患者分为老年组与非老年组两组以及普通型、重型、危重型三组,比较分析重症化预警指标。结果新型冠状病毒肺炎住院患者70例,年龄28~92岁,平均年龄59.2岁。70例COVID-19流行病学特点主要为发病14 d内聚集性发热,其中糖尿病13例(18.57%),高血压22例(31.43%),冠心病5例(7.1%),恶性肿瘤10例(14.29%)。具有2种以上基础疾病的患者预后差,表现为住院时间长,反复出现并发症,甚至出现致死性并发症、急性呼吸窘迫综合征、菌血症、脓毒血症,死亡。本组4例死亡。住院天数、外周血中性粒细胞数高、淋巴细胞数下降、升高的转氨酶和乳酸脱氢酶、高敏C反应蛋白和白细胞介素-6(IL-6)均随病情严重程度的加重而表现出明显升高,差异有统计学意义(均P<0.01)。结论 COVID-19各年龄段人群均易感。普通型重症化的临床预警指标,随病情严重程度而加重。

Objective To analyze the clinical characteristics of hospitalized elderly patients with varying degrees of corona virus disease 2019(COVID-19),hoping to help improve the understanding and management of COVID-19.Methods A total of 70 hospitalized COVID-19 patients with complete clinical data collected between February 7,2020 and April 6,2020 were enrolled.Epidemiological features,underlying conditions,clinical manifestations and treatment outcomes were analyzed.Patients were divided into the elderly group and the non-elderly group based on age and were also divide into the normal group,the severe group and the critical group based on severity.Early warning indicators of severe disease were compared and analyzed.Results Seventy hospitalized COVID-19 patients aged from 28-92 years,with an average age of 59.2 years.Epidemiological characteristics of the patients were mainly clusters of fever within 14 days of onset,with 13(18.57%)patients with diabetes,22(31.43%)with hypertension,5(7.1%)with coronary heart disease and 10(14.29%)with malignant tumor.Patients with more than 2 comorbidity diseases had a poor prognosis,characterized by long hospital stays,recurrent complications and fatal complications.including acute respiratory distress syndrome( ARDS),sepsis and death.In this study,4 patients died.Hospital stays were prolonged,peripheral blood neutrophil count increased,lymphocyte count decreased»and levels of transaminase,lactate dehydrogenase,C-reactive protein and interleukin(IL)-6 were elevated with increasing severity of COVID-19(P<0.01).Conclusions People of all ages are susceptible to COVID-19.Clinical warning signs of exacerbation for the common type become more prominent with increasing severity of COVID-19.