Association Between Age and Clinical Characteristics and Outcomes of Coronavirus Disease 2019

Background: Systematic assessment of the impact of age on the clinical characteristics and outcomes of coronavirus disease 2019 (COVID -19) is crucial for clinicians worldwide to establish risk stratification of patients. Methods: Totally 221 COVID-19 patients from the fever clinics of 117 designated hospitals admitted to Shanghai Public Health Center were enrolled. Data on clinical features, exposure history, radiographic and laboratory findings of them were collected. Different cohorts were generated according to the age of the patients, and clinical features and outcomes were compared. Findings: Difference on the percentage of fever (79·6%) in three groups was not significant. The proportion of bacteria co-infection and antibiotic therapy were higher in patients with age ≥65 years than those in patients younger than 45 years. CURB-65 score of patients was increased successively following the increase of age (p<0·05). Patients older than 45 appeared more bilateral lesions and more lobes affected than those age <45 years (p<0·001). Serological indicators such as Lymphocyte (L), L%, Ca2+, albumin, CD4+T cells showed decrease, while the level of blood urea nitrogen, C-Reactive Protein, lactate dehydrogenase and D-dimer increased following the increasing of the age (p<0·05). The needs of intravenous corticosteroids, heparin therapy and assisted ventilation were higher in those age≥45 years than those age< 45 years. Older patients showed longer time to cure and higher proportion of respiratory failure. Interpretation: Age significantly determined the clinical features and prognosis of the disease. The prognosis was worse in patients older than 60 years, calling for clinicians to pay more attention to patients on this special age. Funding Statement: This work was supported by the National Natural Science Fund for Distinguished Young Scholars to JFX (81925001), Shanghai Leading Talent Program (No. 2016036 to JFX) and the Project of the Shanghai Hospital Development Center (16CR3036A to JFX). Declaration of Interests: All authors declare that they have no competing interests. Ethics Approval Statement: Written informed consent was waived by the Ethics Commission for public health needs to emerging infectious diseases.