Clinical features of 119 old patients with respiratory virus infection

doi:10.3969/j.issn.1674-8115.2021.05.011

Abstract

Abstract: Objective

·To analyze the clinical features and risk factors that possibly affect the clinical outcome of elderly patients with respiratory virus infection.

Methods

·A total of 119 hospitalized patients (≥65 years old) with respiratory virus infection in the Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were enrolled in this study. The clinical symptoms, laboratory examination, treatment course and outcome were analyzed and compared between cured patients and dead patients.

Results

·The average age of the patients was (85.61±7.67) years old, the male to female ratio was 98∶21 and 12 cases were dead. The number of influenza A virus patients (41 cases) was the most. Compared with cured patients, the dead patients were older, and the proportion of cases with bacterial infection or with double pneumonia in chest CT was higher (P<0.05). In the laboratory examination on admission, there were significant differences between the cured patients and the dead patients on leukocyte count, neutrophil count, erythrocyte count, the levels of hemoglobin, serum albumin, urea, and creatinine, and estimated glomerular filtration rate (P<0.05).

Conclusion

·Older age, higher leukocyte count and neutrophil count, lower hemoglobin and albumin levels, renal insufficiency and bacterial infection may be the influencing factors of death in elderly patients with respiratory virus infection.

Key words: the elderly, respiratory virus infection, clinical features

CLC Number:

R563.1

Dao HUANG, Dong WEI, Zhi-hong XU, Jia-an HU. Clinical features of 119 old patients with respiratory virus infection[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(5): 628-631.

Figures/Tables 2

TrendMD

References 17

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Item	Value
Leukocyte count/(×10⁹·L^-1)	7.47±4.14
Neutrophil count/(×10⁹·L^-1)	5.67±3.99
Lymphocyte count/(×10⁹·L^-1)	1.17±0.86
Monocyte count/(×10⁹·L^-1)	0.85±3.21
Erythrocyte count/(×10¹²·L^-1)	3.80±0.84
Hemoglobin/(g·L^-1)	117.41±22.32
Platelet count/(×10⁹·L^-1)	178.64±78.72
Glutamic-pyruvic transaminase/(IU·L^-1)	24.97±55.40
Glutamic-oxaloacetic transaminase/(IU·L^-1)	36.74±76.29
Total bilirubin/(μmol·L^-1)	12.44±6.00
Albumin/(g·L^-1)	34.12±7.03
Urea nitrogen/(mmol·L^-1)	9.30±9.15
Creatinine/(μmol·L^-1)	108.67±81.91
Trioxypurine/(μmol·L^-1)	306.55±107.54
eGFR/(mL·min^-1)	78.27±36.04
Serum natrium/(mmol·L^-1)	137.56±5.05
Serum kalium/(mmol·L^-1)	3.95±0.49
Pro-B-type natriuretic peptide/(pg·mL^-1)	2 310.05±6 547.68
C-reactive protein/(mg·L^-1)	34.24±49.92
Erythrocyte sedimentation rate/(mm·h^-1)	27.39±26.41
Procalcitonin/(ng·mL^-1)	1.37±7.21
Endotoxin (limulus test)/(pg·mL^-1)	22.39±60.55
Pulmonary inflammation showed on chest CT/% (n/n)	53.9 （62/115）
Bilateral pulmonary inflammation showed on chest CT/% (n/n)	41.7 （48/115）

Item	Value
Leukocyte count/(×10⁹·L^-1)	7.47±4.14
Neutrophil count/(×10⁹·L^-1)	5.67±3.99
Lymphocyte count/(×10⁹·L^-1)	1.17±0.86
Monocyte count/(×10⁹·L^-1)	0.85±3.21
Erythrocyte count/(×10¹²·L^-1)	3.80±0.84
Hemoglobin/(g·L^-1)	117.41±22.32
Platelet count/(×10⁹·L^-1)	178.64±78.72
Glutamic-pyruvic transaminase/(IU·L^-1)	24.97±55.40
Glutamic-oxaloacetic transaminase/(IU·L^-1)	36.74±76.29
Total bilirubin/(μmol·L^-1)	12.44±6.00
Albumin/(g·L^-1)	34.12±7.03
Urea nitrogen/(mmol·L^-1)	9.30±9.15
Creatinine/(μmol·L^-1)	108.67±81.91
Trioxypurine/(μmol·L^-1)	306.55±107.54
eGFR/(mL·min^-1)	78.27±36.04
Serum natrium/(mmol·L^-1)	137.56±5.05
Serum kalium/(mmol·L^-1)	3.95±0.49
Pro-B-type natriuretic peptide/(pg·mL^-1)	2 310.05±6 547.68
C-reactive protein/(mg·L^-1)	34.24±49.92
Erythrocyte sedimentation rate/(mm·h^-1)	27.39±26.41
Procalcitonin/(ng·mL^-1)	1.37±7.21
Endotoxin (limulus test)/(pg·mL^-1)	22.39±60.55
Pulmonary inflammation showed on chest CT/% (n/n)	53.9 （62/115）
Bilateral pulmonary inflammation showed on chest CT/% (n/n)	41.7 （48/115）

Item	Cured cases (n=107)	Death cases (n=12)	P value
Male/n(%)	89 (83.2)	9 (75.0)	0.442
Age/year	85.10±7.86	89.80±3.84	0.002
Temperature/℃	37.29±0.71	37.02±0.63	0.201
Complication/n(%)
Diabetes	28 (26.2)	3 (25.0)	1.000
Hypertension	80 (74.8)	9 (75.0)	1.000
Coronary heart disease	10 (9.3)	1 (8.3)	1.000
Cardiac failure	32 (29.9)	5 (41.7)	0.512
Cerebral stroke	8 (7.5)	1 (8.3)	1.000
Chronic obstructive pulmonary disease	13 (12.1)	4 (33.3)	0.069
Cancer	33 (30.8)	3 (25.0)	1.000
Chronic kidney disease	56 (52.3)	9 (75.0)	0.221
Complicated with bacterial infection	31 (33.0)	8 (66.7)	0.029
Smoking or prior smoking	22 (20.6)	5 (41.7)	0.140
Leukocyte count/(×10⁹·L^-1)	7.14±3.86	10.39±5.49	0.009
Neutrophil count/(×10⁹·L^-1)	5.35±3.71	8.55±5.34	0.008
Lymphocyte count/(×10⁹·L^-1)	1.17±0.87	1.15±0.81	0.939
Monocyte count/(×10⁹·L^-1)	0.89±3.38	0.51±0.24	0.703
Erythrocyte count/(×10¹²·L^-1)	3.89±0.83	3.06±0.55	0.001
Hemoglobin/(g·L^-1)	120.00±21.03	94.33±20.88	0.001
Platelet count/(×10⁹·L^-1)	178.09±77.34	183.58±93.79	0.820
Glutamic-pyruvic transaminase/(IU·L^-1)	25.80±58.24	17.58±13.41	0.628
Glutamic-oxaloacetic transaminase/(IU·L^-1)	33.13±61.19	68.92±158.41	0.454
Total bilirubin/(μmol·L^-1)	12.43±6.08	12.53±5.46	0.955
Albumin/(g·L^-1)	34.84±6.89	27.67±4.83	0.001
Urea nitrogen/(mmol·L^-1)	8.32±8.07	17.97±12.32	0.030
Creatinine/(μmol·L^-1)	95.14±40.45	229.33±196.30	0.037
Trioxypurine/(μmol·L^-1)	302.45±105.22	342.75±125.44	0.220
eGFR/(mL·min^-1)	81.52±34.61	49.24±36.98	0.003
Serum natrium/(mmol·L^-1)	137.55±4.79	137.67±7.22	0.941
Serum kalium/(mmol·L^-1)	3.92±0.44	4.27±0.78	0.142
Pro-B-type natriuretic peptide/(pg·mL^-1)	1 677.66±5 153.01	7 948.88±12 862.50	0.121
C-reactive protein/(mg·L^-1)	31.29±46.73	60.61±69.57	0.180
Erythrocyte sedimentation rate/(mm·h^-1)	25.68±25.02	44.88±35.24	0.172
Procalcitonin/(ng·mL^-1)	1.52±7.62	0.19±0.18	0.549
Endotoxin (limulus test)/(pg·mL^-1)	24.11±63.83	7.8±0.00	0.380
Bilateral pulmonary inflammation showed on chest CT/n(%)	39 (37.9)	9 (75.0)	0.044
Days of using antibiotics/d	10.24±4.22	11.33±2.78	0.386

Item	Cured cases (n=107)	Death cases (n=12)	P value
Male/n(%)	89 (83.2)	9 (75.0)	0.442
Age/year	85.10±7.86	89.80±3.84	0.002
Temperature/℃	37.29±0.71	37.02±0.63	0.201
Complication/n(%)
Diabetes	28 (26.2)	3 (25.0)	1.000
Hypertension	80 (74.8)	9 (75.0)	1.000
Coronary heart disease	10 (9.3)	1 (8.3)	1.000
Cardiac failure	32 (29.9)	5 (41.7)	0.512
Cerebral stroke	8 (7.5)	1 (8.3)	1.000
Chronic obstructive pulmonary disease	13 (12.1)	4 (33.3)	0.069
Cancer	33 (30.8)	3 (25.0)	1.000
Chronic kidney disease	56 (52.3)	9 (75.0)	0.221
Complicated with bacterial infection	31 (33.0)	8 (66.7)	0.029
Smoking or prior smoking	22 (20.6)	5 (41.7)	0.140
Leukocyte count/(×10⁹·L^-1)	7.14±3.86	10.39±5.49	0.009
Neutrophil count/(×10⁹·L^-1)	5.35±3.71	8.55±5.34	0.008
Lymphocyte count/(×10⁹·L^-1)	1.17±0.87	1.15±0.81	0.939
Monocyte count/(×10⁹·L^-1)	0.89±3.38	0.51±0.24	0.703
Erythrocyte count/(×10¹²·L^-1)	3.89±0.83	3.06±0.55	0.001
Hemoglobin/(g·L^-1)	120.00±21.03	94.33±20.88	0.001
Platelet count/(×10⁹·L^-1)	178.09±77.34	183.58±93.79	0.820
Glutamic-pyruvic transaminase/(IU·L^-1)	25.80±58.24	17.58±13.41	0.628
Glutamic-oxaloacetic transaminase/(IU·L^-1)	33.13±61.19	68.92±158.41	0.454
Total bilirubin/(μmol·L^-1)	12.43±6.08	12.53±5.46	0.955
Albumin/(g·L^-1)	34.84±6.89	27.67±4.83	0.001
Urea nitrogen/(mmol·L^-1)	8.32±8.07	17.97±12.32	0.030
Creatinine/(μmol·L^-1)	95.14±40.45	229.33±196.30	0.037
Trioxypurine/(μmol·L^-1)	302.45±105.22	342.75±125.44	0.220
eGFR/(mL·min^-1)	81.52±34.61	49.24±36.98	0.003
Serum natrium/(mmol·L^-1)	137.55±4.79	137.67±7.22	0.941
Serum kalium/(mmol·L^-1)	3.92±0.44	4.27±0.78	0.142
Pro-B-type natriuretic peptide/(pg·mL^-1)	1 677.66±5 153.01	7 948.88±12 862.50	0.121
C-reactive protein/(mg·L^-1)	31.29±46.73	60.61±69.57	0.180
Erythrocyte sedimentation rate/(mm·h^-1)	25.68±25.02	44.88±35.24	0.172
Procalcitonin/(ng·mL^-1)	1.52±7.62	0.19±0.18	0.549
Endotoxin (limulus test)/(pg·mL^-1)	24.11±63.83	7.8±0.00	0.380
Bilateral pulmonary inflammation showed on chest CT/n(%)	39 (37.9)	9 (75.0)	0.044
Days of using antibiotics/d	10.24±4.22	11.33±2.78	0.386

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