OBJECTIVE To investigate the characteristics and prognostic factors in the elderly patients with COVID-19. METHODS Consecutive cases over 60 years old with COVID-19 in Renmin Hospital of Wuhan University from Jan 1 to Feb 6, 2020 were included. The primary outcomes were death and survival till March 5. Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes. Cox regression was performed for prognostic factors. RESULTS 339 patients with COVID-19 (aged 71±8 years,173 females (51%)) were enrolled, including 80 (23.6%) critical, 159 severe (46.9%) and 100 moderate (29.5%) cases. Common comorbidities were hypertension (40.8%), diabetes (16.0%) and cardiovascular disease (15.7%). Common symptoms included fever (92.0%), cough (53.0%), dyspnea (40.8%) and fatigue (39.9%). Lymphocytopenia was a common laboratory finding (63.2%). Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%). Till Mar 5, 2020, 91 cases were discharged (26.8%), 183 cases stayed in hospital (54.0%) and 65 cases (19.2%) were dead. Shorter length of stay was found for the dead compared with the survivors (5 (3-8) vs. 28 (26-29), P < 0.001). Symptoms of dyspnea (HR 2.35, P = 0.001), comorbidities including cardiovascular disease (HR 1.86, P = 0.031) and chronic obstructive pulmonary disease (HR 2.24, P = 0.023), and acute respiratory distress syndrome (HR 29.33, P < 0.001) were strong predictors of death. And a high level of lymphocytes was predictive of better outcome (HR 0.10, P < 0.001). CONCLUSIONS High proportion of severe to critical cases and high fatality rate were observed in the elderly COVID-19 patients. Rapid disease progress was noted in the dead with a median survival time of 5 days after admission. Dyspnea, lymphocytopenia, comorbidities including cardiovascular disease and chronic obstructive pulmonary disease, and acute respiratory distress syndrome were predictive of poor outcome. Close monitoring and timely treatment should be performed for the elderly patients at high risk.

中文翻译：

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老年患者 2019 年冠状病毒病：基于 4 周随访的特征和预后因素。

目的 探讨老年COVID-19患者的特征及预后因素。方法纳入2020年1月1日至2月6日在武汉大学人民医院确诊的60岁以上连续感染COVID-19病例。主要结局是截至 3 月 5 日的死亡和生存。收集了人口统计学、临床特征、合并症、实验室检查和并发症的数据，并比较了不同的结局。对预后因素进行 Cox 回归。结果 共纳入 339 例 COVID-19 患者（年龄 71±8 岁，女性 173 例（51%）），其中重症 80 例（23.6%），重症 159 例（46.9%），中度 100 例（29.5%）。常见合并症为高血压（40.8%）、糖尿病（16.0%）和心血管疾病（15.7%）。常见症状包括发烧（92.0%）、咳嗽（53.0%）、呼吸困难（40.8%）和疲劳（39.9%）。淋巴细胞减少症是常见的实验室检查结果 (63.2%)。常见并发症包括细菌感染（42.8%）、肝酶异常（28.7%）和急性呼吸窘迫综合征（21.0%）。截至2020年3月5日，已有91例出院（26.8%），183例住院（54.0%），65例（19.2%）死亡。与幸存者相比，死者的住院时间较短（5 人 (3-8) 比 28 (26-29)，P < 0.001）。呼吸困难症状（HR 2.35，P = 0.001）、合并症包括心血管疾病（HR 1.86，P = 0.031）和慢性阻塞性肺疾病（HR 2.24，P = 0.023）以及急性呼吸窘迫综合征（HR 29.33，P < 0.001） ）是死亡的有力预测因子。高水平的淋巴细胞预示着更好的结果（HR 0.10，P < 0.001）。结论老年COVID-19患者重症危重症比例高，病死率高。死亡者的疾病进展迅速，入院后中位生存时间为 5 天。呼吸困难、淋巴细胞减少、心血管疾病和慢性阻塞性肺病等合并症以及急性呼吸窘迫综合征是预后不良的预测因素。对高危老年患者应严密监测并及时治疗。