The date of disease onset was defined as the day when the symptoms were noticed by the patient, including fever, cough, chest tightness, dyspnea, muscle pain et al. Department of Infectious Diseases, Zhongnan Hospital of Wuhan University. Various therapies, including oxygen therapy, mechanical ventilation, expectorant, antiviral treatment, and corticosteroid therapy were initiated in 60.6%, 19.2%, 32.5%, 62.9%, and 52.7% of patients, respectively. Sputum and throat swab specimens were collected from all patients upon admission and tested by real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 RNA within 3 hours. This means it is still under development and may contain inaccuracies. In total, 203 patients were diagnosed with COVID-19, with a median age of 54 years (interquartile range, 41–68; range, 20–91 years). These three authors contributed equally to this study. In multivariate analysis, posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio were indicated as independent predictors of poor efficacy. The mortality of SARSCoV has been reported as more than 10%, while MERSCoV has been reported to be higher than 35% (14). The subsets showed a significant association with inflammatory status in COVID-19, especially CD8 + T cells and CD4 + /CD8 + ratio. Potential conflicts of interest. The median age was 60 years (IQR, 38–66), and 22 patients (37%) were male. Most patients received antiviral treatment with arbidol (200 mg twice daily), interferon-alpha inhalation (50 µg twice daily), or lopinavir and ritonavir (400 mg twice daily and 100 mg twice daily, respectively). Search for other works by this author on: Department of Endocrinology, Zhongnan Hospital of Wuhan University, Department of Infectious Diseases, Shanghai Fifth People’s Hospital of Fudan University. Categorical data were described as percentages and continuous data as median with interquartile range (IQR). In this study, virologic quantification was used as an index to assess disease progression. (a and b): January 21th 48-year-old female, doctor, routine lung CT examination showed normal presentation; (c and d): February 5th patient has a fever after a day of fatigue, with body temperature of 38 degrees, urgent examination of throat swabs and positive SARS-CoV-2 test, CT examination showed a few patchy shadows of the right upper lung; (e and f): February 6th admitted to the hospital, still have fever, February 12th patient complained chest tightness and shortness of breath, review of CT showed, exudative lesions in both lungs increased significantly compared with the previous, patient was transferred to intensive care unit (ICU), tracheal intubation the next day, is still under treatment in the ICU. Epidemiological, clinical, laboratory, and radiological characteristics, along with treatment and outcome data, were obtained from electronic medical records. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia is a newly recognized illness that initially spread from Wuhan (Hubei province) to other regions of China, before rapidly spreading around the world (3–6). General Update: Today, for the first time, the number of newly diagnosed cases in Wuhan, China is 0 . A total of 203 patients were diagnosed with COVID-19, with a median age of 54 years (IQR, 41–68; range, 20–91 years). The findings from this study will improve the awareness of COVID-19 pneumonia and may help enhance patient care in the future. Among COVID-19 patients, severe cases had a lower level of total lymphocytes, CD4+ T cells, CD8+ T cells, and B cells than mild cases, which was similar to the alteration in SARS [15, 16]. Patient recovered promptly after plasma exchange (PE) followed by IVIg, without mechanical ventilation or intensive care. Total lymphocytes, CD4 + T cells, CD8 + T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Thymosin α1 can markedly prolonged the hospital length of stay (P = 0.024) as well as the total duration of the disease (P = 0.001) in the critical type COVID-19 patients. Isolated from thymus gland; octaeicosapeptide; one of the polypeptides of thymosin fraction V; FDA approved orphan drug status for malignant melanoma although mechanism uncertain. Note: CI = confidence interval; OR = odds ratio. Men accounted for 108 (53.2%) of the cases, and 55 patients (27.1%) were more than 65 years of age. Nine significant factors in the univariate analysis were put into the multivariate analysis to identify independent factors associated with the death of older patients (Table 4). In addition, older patients may be more prone to bacterial infections, liver and kidney dysfunction, and changes in blood glucose and coagulation levels. F. W., J. N., and H. W. contributed equally to this study. However, the mortality rate of older patients was significantly higher, at 34.5% (19/55). Thus, we conducted a multivariate analysis to evaluate the effects of these potential confounders, and identified posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio as independent predictors for poor clinical efficacy, especially CD8+ T cells. Immunologic Factors. Samples of EDTA anticoagulated peripheral blood (2 mL) were collected from patients with COVID-19 before initial treatment and a second sample was collected after 1 week of treatment. TieLong Chen, MD, Zhe Dai, MD, Pingzheng Mo, MD, Xinyu Li, MD, Zhiyong Ma, MD, Shihui Song, MD, Xiaoping Chen, MD, Mingqi Luo, MD, Ke Liang, MD, Shicheng Gao, MD, Yongxi Zhang, MD, Liping Deng, MD, Yong Xiong, MD, Clinical Characteristics and Outcomes of Older Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Single-Centered, Retrospective Study, The Journals of Gerontology: Series A, Volume 75, Issue 9, 1 September 2020, Pages 1788–1795, https://doi.org/10.1093/gerona/glaa089. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the ability of lymphocyte subsets in predicting treatment efficacy. Twenty-one patients (10.3%) had pleural effusion (Figure 2). These authors have contributed equally to the work. Through a multivariate analysis of the causes of death in older patients, we found that males, comorbidities, time from disease onset to hospitalization, abnormal kidney function, and elevated procalcitonin levels were all significantly associated with death.
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