Research Paper|Volume 12, Issue 13|pp 12504—12516

Risk factors influencing the prognosis of elderly patients infected with COVID-19: a clinical retrospective study in Wuhan, China

Shan Gao^1,⁶, Fang Jiang^2,⁶, Wei Jin^3,⁶, Yuan Shi¹, Leilei Yang¹, Yanqiong Xia¹, Linyan Jia¹, Bo Wang¹, Han Lin⁵, Yin Cai^2,⁷, Zhengyuan Xia^2,^4,^5,⁷, Jian Peng^1,⁷

¹Department of Anesthesiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, Hubei, China
²Department of Anesthesiology, The University of Hong Kong, Hong Kong, China
³Department of Pain Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, Hubei, China
⁴Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
⁵Department of Anesthesiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
⁶Co-first authors
⁷Co-last authors

Received: May 2, 2020Accepted: June 20, 2020Published: July 11, 2020

https://doi.org/10.18632/aging.103631

Copyright © 2020 Gao et al. This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 3.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The mortality rate of elderly patients with Coronavirus Disease 2019 (COVID-19) was significantly higher than the overall mortality rate. However, besides age, leading death risk factors for the high mortality in elderly patients remain unidentified. This retrospective study included 210 elderly COVID-19 patients (aged ≥ 65 years), of whom 175 patients were discharged and 35 died. All deceased patients had at least one comorbidity. A significantly higher proportion of patients in the deceased group had cardiovascular diseases (49% vs. 20%), respiratory diseases (51% vs. 11%), chronic kidney disease (29% vs. 5%) and cerebrovascular disease (20% vs. 3%) than that in the discharged group. The median levels of C-reactive protein (125.8mg/L vs. 9.3mg/L) and blood urea nitrogen (7.2mmol/L vs. 4.4mmol/L) were significantly higher and median lymphocyte counts (0.7×10⁹/L vs. 1.1×10⁹/L) significantly lower in the deceased group than those in the discharged group. The survival curve analysis showed that higher C-reactive protein (≥5mg/L) plus any other abnormalities of lymphocyte, blood urea nitrogen or lactate dehydrogenase significantly predicted poor prognosis of COVID-19 infected elderly patients. This study revealed that the risk factors for the death in these elderly patients included comorbidities, increased levels of C-reactive protein and blood urea nitrogen, and lymphopenia during hospitalization.