225例老年新型冠状病毒肺炎患者的临床特点分析

Analysis of clinical characteristics of 225 elderly patients with COVID-19

目的探讨老年新型冠状病毒肺炎(COVID-19)患者的临床特点。方法回顾性分析2020年1月25日至3月20日在武汉市第四医院收治的225例确诊的65岁以上的COVID-19患者,将其分为轻型、普通型、重型及危重型4组,收集并比较4组患者的临床资料,分析临床特点。结果225例患者中轻型4例(1.8%),普通型150例(66.7%),重型51例(22.7%),危重型20例(8.9%)。临床表现包括不同程度的发热、咳嗽、咳痰、胸闷喘息、胸痛、呼吸困难、乏力、腹泻、纳差、头昏、头痛,少数患者有咽部不适、鼻塞、流涕、全身肌痛、心悸等症状。白细胞计数(WBC)可正常、升高或降低,淋巴细胞计数(LYM)正常或不同程度的降低。绝大多数患者出现了不同程度的低蛋白血症,部分患者出现了红细胞沉降率(ESR)、C-反应蛋白(CRP)、D-二聚体升高,少数患者有乳酸脱氢酶(LDH)升高。肺部影像改变以双侧病变居多。225例患者中死亡15例(6.7%),其中重型2例,危重型13例。结论老年COVID-19患者以呼吸道症状表现居多,合并多系统临床表现,重型、危重型患者病死率较高。

Objective To investigate the clinical characteristics of elderly patients with new coronavirus pneumonia(COVID-19).Methods A retrospective analysis of 225 confirmed COVID-19 patients over 65 years of age who were admitted to the Fourth Hospital of Wuhan from January 25 to March 20,2020,was divided into mild,normal,severe and critical groups.Clinical data of 4 groups of patients were collected and compared,and clinical characteristics of 4 groups of patients were analyzed.Results Among the 225 patients,4 were mild(1.8%),150 were common(66.7%),51 were severe(22.7%),and 20 were critical(8.9%).The clinical manifestations of the 4 groups of patients included different degrees of fever,cough and sputum,chest tightness and wheezing,chest pain,dyspnea,fatigue,diarrhea,anorexia,dizziness,headache,and a few patients had throat discomfort,nasal congestion,runny nose,systemic myalgia and palpitations.The white blood cell count can be normal,increased or decreased,and the lymphocyte count was normal or decreased to varying degrees.The vast majority of patients in the four groups experienced varying degrees of hypoproteinemia,and some patients had increased erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and D-dimer,and a few patients had lactate dehydrogenase(LDH)increased.The pulmonary imaging changes were mostly bilateral lesions.Among the 225 patients,15 cases dided,including 2 cases of the severe group and 13 cases of the critical group.Conclusions Elderly COVID-19 patients mostly present with respiratory symptoms,combined with multi-system clinical manifestations.The mortality rate of severe and critical patients was high.