Clinical and Imaging Features of Novel Coronavirus Pneumonia in the Elderly Compared with Young and Middle-Aged Individuals

Abstract

Background: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported worldwide, but there are few reports on age-related computed tomography (CT) signs and clinical characteristics of COVID-19 patients. Objectives: We aimed to analyze the CT imaging characteristics and clinical features of elderly patients with novel COVID-19 and compare them with young COVID-19 patients, in order to provide imaging basis for clinical diagnosis. Patients and Methods: The clinical and chest CT imaging data of elderly patients (≥ 60 years) and young patients (age of 20 - 60 years) with positive novel coronavirus nucleic acid admitted to our hospital from January 28, 2020 to February 16, 2020 were retrospectively analyzed, and the differences in clinical and imaging characteristics between the two groups were compared. Results: One hundred eighty three COVID-19 patients (96 elderly: mean age, 72.76 ± 5.65; 87 young: mean age, 42.69 ± 12.44) with positive novel coronavirus nucleic acid were retrospectively enrolled. The clinical symptoms of fever (79%), cough (64%) and weakness (59%) in elderly patients were higher than those of young patients (P < 0.01). Asymptomatic young patients (15%) were more common than the elderly (2%) (P < 0.01). Twenty-four patients (13%) had lesions that involved both the periphery and the center of the lung, while the lesions were located in the periphery of the lung in 159 patients (87%). Ground-glass opacification in young patients (71%) was significantly higher than that of the elderly (26%) (P < 0.001). Compared with the young group (37%), the proportion of extensive involvement of lung lobes was higher in the elderly group (72%) (P < 0.001). Conclusion: Elderly and young patients with corona virus disease had some common CT and clinical features, but elderly patients may have relatively severe CT findings, and these differences may be related to the severity and prognosis of COVID-19 pneumonia.