老年新型冠状病毒肺炎50例临床特征及危险因素分析

目的分析50例老年新型冠状病毒肺炎(COVID-19)患者的临床资料,为COVID-19老年患者的诊疗提供借鉴和思考。方法收集2020年1月26日-3月10日在重庆市公共卫生医疗救治中心收治的50例确诊COVID-19老年患者的临床资料。根据疾病严重程度,分为非重症组(n=34)和重症组(n=16),分析两组患者的临床表现、实验室检查结果等。采用SPSS 23.0统计软件进行数据分析。结果首发症状中,重症组患者发热、咯痰、气促的比例高于非重症组(P<0.05)。重症组患者的C反应蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、乳酸脱氢酶高于非重症组(P<0.05);淋巴细胞计数、CD4^+T淋巴细胞计数、CD8^+T淋巴细胞计数均低于非重症组(P<0.05)。合并细菌性肺炎患者较未合并细菌性肺炎患者的病毒核酸转阴时间长(P<0.05)。高龄、咯痰、CD8^+T淋巴细胞计数下降是老年COVID-19患者疾病严重的独立危险因素。结论老年COVID-19患者的疾病严重程度与高龄、咯痰、CD8^+T淋巴细胞计数下降相关;合并细菌性肺炎患者病毒核酸转阴时间长。

Clinical characteristics and risk factors of coronavirus disease 2019 in 50 elderly patients

Objective To analyze the clinical data of 50 elderly patients with coronavirus disease 2019(COVID-19)for improving the diagnosis and treatment of COVID-19.Methods The clinical data of 50 COVID-19 patients admitted to Chongqing Public Health Medical Center from January 26,2020 to March 10,2020 were collected.The patients were assigned to non-severe group(n=34)or severe group(n=16)according to the severity of disease.The clinical manifestations and laboratory tests were reviewed and compared between the two groups.SPSS 23.0 statistical software was used for data analysis.Results More severe patients had fever,cough,and shortness of breath at disease onset than the non-severe patients(P<0.05).Severe patients had significantly higher serum C-reactive protein,alanine aminotransferase,aspartate aminotransferase,and lactate dehydrogenase levels than non-severe patients(all P<0.05),but significantly lower lymphocyte count,CD4^+T lymphocyte count,and CD8^+T lymphocyte count than nonsevere patients(all P<0.05).The patients complicated with bacterial pneumonia required longer time to achieve negative result of viral nucleic acid test than the patients without bacterial pneumonia(P<0.05).Advanced age,expectoration,and decreased CD8^+T lymphocytes count were independent risk factors for severe COVID-19 disease in elderly patients.Conclusions The severity of COVID-19 in elderly patients is related to advanced age,expectoration,and decreased CD8^+T lymphocytes count.Longer time is required for the elderly COVID-19 patients complicated with bacterial pneumonia to achieve negative result of viral nucleic acid test.