Clinical features of COVID-19 pneumonia in elderly patients

Abstract

Background: the elderly may represent a specific cluster of high-risk patients for developing COVID-19 pneumonia with rapidly progressive clinical deterioration.

Aim: evaluate the differences in clinical, biological and radiological characteristics between elderly and younger pulmonary COVID-19 patients.

Methods: a retrospective comparative study was performed between november 2020 and january 2021. Ninety-two patients with confirmed COVID-19 pneumonia were included and divided into 2 groups:  elderly patients (≥65 years):(n=46) and young patients (≤64 years):(n=46).

Results: the average age of the elderly patients was 71.65years. Compared to young patients, elderly patients had more severe form of COVID-19 pneumonia(71.7%vs 41.3%, p=0.01) and the hospital stay was longer(12.26vs 8.15days, p=0.009). Elderly patients had a higher tobacco consumption(p=0.007) and number of underlying diseases(93.5%vs78%, p=0.03) including hypertension(p=0.007) and coronary artery disease(p=0.007). Memory impairment was higher in the elderly patients(13%vs 0%, p =0.02). Fever(60.9%vs 80.4%, p=0.03), ageusia (10.9%vs 28.3%, p=0.02) and arthromyalgia(54.3% vs 76.1%, p=0.02) were less in the elderly patients. The D-dimer(p=0.04), LDH(p=0.04) and bilirubin(p=0.06) levels were higher in the elderly patients. Bleeding complications(p=0.02) and functional renal failure(p=0.02) were higher in the elderly patients. Main radiological features, lymphopenia, Creactive protein level and admission into the intensive care unit were similar in both groups. COVID-19 pneumonia-related mortality was noticed in five old patients.

Measurements and Main Results: COVID-19 pneumonia in elderly patients showed higher frequencies of comorbidities, complications and atypical clinical presentations.