Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up.
Identifieur interne : 000385 ( Main/Corpus ); précédent : 000384; suivant : 000386Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up.
Auteurs : Lang Wang ; Wenbo He ; Xiaomei Yu ; Dalong Hu ; Mingwei Bao ; Huafen Liu ; Jiali Zhou ; Hong JiangSource :
- The Journal of infection [ 1532-2742 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (isolation & purification), China (epidemiology), Comorbidity (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Coronavirus Infections (mortality), Coronavirus Infections (pathology), Female (MeSH), Follow-Up Studies (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (epidemiology), Pneumonia, Viral (mortality), Pneumonia, Viral (pathology), Prognosis (MeSH), Survival Analysis (MeSH).
- MESH :
- geographic , epidemiology : China.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- isolation & purification : Betacoronavirus.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- pathology : Coronavirus Infections, Pneumonia, Viral.
- Aged, Comorbidity, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pandemics, Prognosis, Survival Analysis.
Abstract
OBJECTIVE
To investigate the characteristics and prognostic factors in the elderly patients with COVID-19.
METHODS
Consecutive cases over 60 years old with COVID-19 in Renmin Hospital of Wuhan University from Jan 1 to Feb 6, 2020 were included. The primary outcomes were death and survival till March 5. Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes. Cox regression was performed for prognostic factors.
RESULTS
339 patients with COVID-19 (aged 71±8 years,173 females (51%)) were enrolled, including 80 (23.6%) critical, 159 severe (46.9%) and 100 moderate (29.5%) cases. Common comorbidities were hypertension (40.8%), diabetes (16.0%) and cardiovascular disease (15.7%). Common symptoms included fever (92.0%), cough (53.0%), dyspnea (40.8%) and fatigue (39.9%). Lymphocytopenia was a common laboratory finding (63.2%). Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%). Till Mar 5, 2020, 91 cases were discharged (26.8%), 183 cases stayed in hospital (54.0%) and 65 cases (19.2%) were dead. Shorter length of stay was found for the dead compared with the survivors (5 (3-8) vs. 28 (26-29), P < 0.001). Symptoms of dyspnea (HR 2.35, P = 0.001), comorbidities including cardiovascular disease (HR 1.86, P = 0.031) and chronic obstructive pulmonary disease (HR 2.24, P = 0.023), and acute respiratory distress syndrome (HR 29.33, P < 0.001) were strong predictors of death. And a high level of lymphocytes was predictive of better outcome (HR 0.10, P < 0.001).
CONCLUSIONS
High proportion of severe to critical cases and high fatality rate were observed in the elderly COVID-19 patients. Rapid disease progress was noted in the dead with a median survival time of 5 days after admission. Dyspnea, lymphocytopenia, comorbidities including cardiovascular disease and chronic obstructive pulmonary disease, and acute respiratory distress syndrome were predictive of poor outcome. Close monitoring and timely treatment should be performed for the elderly patients at high risk.
DOI: 10.1016/j.jinf.2020.03.019
PubMed: 32240670
PubMed Central: PMC7118526
Links to Exploration step
pubmed:32240670Le document en format XML
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Electronic address: hong-jiang@whu.edu.cn.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32240670</idno><idno type="pmid">32240670</idno><idno type="doi">10.1016/j.jinf.2020.03.019</idno><idno type="pmc">PMC7118526</idno><idno type="wicri:Area/Main/Corpus">000385</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000385</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up.</title><author><name sortKey="Wang, Lang" sort="Wang, Lang" uniqKey="Wang L" first="Lang" last="Wang">Lang Wang</name><affiliation><nlm:affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</nlm:affiliation></affiliation></author><author><name sortKey="He, Wenbo" sort="He, Wenbo" uniqKey="He W" first="Wenbo" last="He">Wenbo He</name><affiliation><nlm:affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</nlm:affiliation></affiliation></author><author><name sortKey="Yu, Xiaomei" sort="Yu, Xiaomei" uniqKey="Yu X" first="Xiaomei" last="Yu">Xiaomei Yu</name><affiliation><nlm:affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</nlm:affiliation></affiliation></author><author><name sortKey="Hu, Dalong" sort="Hu, Dalong" uniqKey="Hu D" first="Dalong" last="Hu">Dalong Hu</name><affiliation><nlm:affiliation>School of Biotechnology and Biomolecular Sciences, The University of New South Wales, NSW 2052, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bao, Mingwei" sort="Bao, Mingwei" uniqKey="Bao M" first="Mingwei" last="Bao">Mingwei Bao</name><affiliation><nlm:affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Huafen" sort="Liu, Huafen" uniqKey="Liu H" first="Huafen" last="Liu">Huafen Liu</name><affiliation><nlm:affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhou, Jiali" sort="Zhou, Jiali" uniqKey="Zhou J" first="Jiali" last="Zhou">Jiali Zhou</name><affiliation><nlm:affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China.</nlm:affiliation></affiliation></author><author><name sortKey="Jiang, Hong" sort="Jiang, Hong" uniqKey="Jiang H" first="Hong" last="Jiang">Hong Jiang</name><affiliation><nlm:affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. Electronic address: hong-jiang@whu.edu.cn.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The Journal of infection</title><idno type="eISSN">1532-2742</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Betacoronavirus (isolation & purification)</term><term>China (epidemiology)</term><term>Comorbidity (MeSH)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (mortality)</term><term>Coronavirus Infections (pathology)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (mortality)</term><term>Pneumonia, Viral (pathology)</term><term>Prognosis (MeSH)</term><term>Survival Analysis (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>China</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Comorbidity</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Prognosis</term><term>Survival Analysis</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To investigate the characteristics and prognostic factors in the elderly patients with COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Consecutive cases over 60 years old with COVID-19 in Renmin Hospital of Wuhan University from Jan 1 to Feb 6, 2020 were included. The primary outcomes were death and survival till March 5. Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes. Cox regression was performed for prognostic factors.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>339 patients with COVID-19 (aged 71±8 years,173 females (51%)) were enrolled, including 80 (23.6%) critical, 159 severe (46.9%) and 100 moderate (29.5%) cases. Common comorbidities were hypertension (40.8%), diabetes (16.0%) and cardiovascular disease (15.7%). Common symptoms included fever (92.0%), cough (53.0%), dyspnea (40.8%) and fatigue (39.9%). Lymphocytopenia was a common laboratory finding (63.2%). Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%). Till Mar 5, 2020, 91 cases were discharged (26.8%), 183 cases stayed in hospital (54.0%) and 65 cases (19.2%) were dead. Shorter length of stay was found for the dead compared with the survivors (5 (3-8) vs. 28 (26-29), P < 0.001). Symptoms of dyspnea (HR 2.35, P = 0.001), comorbidities including cardiovascular disease (HR 1.86, P = 0.031) and chronic obstructive pulmonary disease (HR 2.24, P = 0.023), and acute respiratory distress syndrome (HR 29.33, P < 0.001) were strong predictors of death. And a high level of lymphocytes was predictive of better outcome (HR 0.10, P < 0.001).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>High proportion of severe to critical cases and high fatality rate were observed in the elderly COVID-19 patients. Rapid disease progress was noted in the dead with a median survival time of 5 days after admission. Dyspnea, lymphocytopenia, comorbidities including cardiovascular disease and chronic obstructive pulmonary disease, and acute respiratory distress syndrome were predictive of poor outcome. Close monitoring and timely treatment should be performed for the elderly patients at high risk.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32240670</PMID><DateCompleted><Year>2020</Year><Month>05</Month><Day>20</Day></DateCompleted><DateRevised><Year>2020</Year><Month>05</Month><Day>26</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1532-2742</ISSN><JournalIssue CitedMedium="Internet"><Volume>80</Volume><Issue>6</Issue><PubDate><Year>2020</Year><Month>06</Month></PubDate></JournalIssue><Title>The Journal of infection</Title><ISOAbbreviation>J. Infect.</ISOAbbreviation></Journal><ArticleTitle>Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up.</ArticleTitle><Pagination><MedlinePgn>639-645</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0163-4453(20)30146-8</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jinf.2020.03.019</ELocationID><Abstract><AbstractText Label="OBJECTIVE">To investigate the characteristics and prognostic factors in the elderly patients with COVID-19.</AbstractText><AbstractText Label="METHODS">Consecutive cases over 60 years old with COVID-19 in Renmin Hospital of Wuhan University from Jan 1 to Feb 6, 2020 were included. The primary outcomes were death and survival till March 5. Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes. Cox regression was performed for prognostic factors.</AbstractText><AbstractText Label="RESULTS">339 patients with COVID-19 (aged 71±8 years,173 females (51%)) were enrolled, including 80 (23.6%) critical, 159 severe (46.9%) and 100 moderate (29.5%) cases. Common comorbidities were hypertension (40.8%), diabetes (16.0%) and cardiovascular disease (15.7%). Common symptoms included fever (92.0%), cough (53.0%), dyspnea (40.8%) and fatigue (39.9%). Lymphocytopenia was a common laboratory finding (63.2%). Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%). Till Mar 5, 2020, 91 cases were discharged (26.8%), 183 cases stayed in hospital (54.0%) and 65 cases (19.2%) were dead. Shorter length of stay was found for the dead compared with the survivors (5 (3-8) vs. 28 (26-29), P < 0.001). Symptoms of dyspnea (HR 2.35, P = 0.001), comorbidities including cardiovascular disease (HR 1.86, P = 0.031) and chronic obstructive pulmonary disease (HR 2.24, P = 0.023), and acute respiratory distress syndrome (HR 29.33, P < 0.001) were strong predictors of death. And a high level of lymphocytes was predictive of better outcome (HR 0.10, P < 0.001).</AbstractText><AbstractText Label="CONCLUSIONS">High proportion of severe to critical cases and high fatality rate were observed in the elderly COVID-19 patients. Rapid disease progress was noted in the dead with a median survival time of 5 days after admission. Dyspnea, lymphocytopenia, comorbidities including cardiovascular disease and chronic obstructive pulmonary disease, and acute respiratory distress syndrome were predictive of poor outcome. Close monitoring and timely treatment should be performed for the elderly patients at high risk.</AbstractText><CopyrightInformation>Copyright © 2020. Published by Elsevier Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Lang</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>He</LastName><ForeName>Wenbo</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yu</LastName><ForeName>Xiaomei</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hu</LastName><ForeName>Dalong</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>School of Biotechnology and Biomolecular Sciences, The University of New South Wales, NSW 2052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bao</LastName><ForeName>Mingwei</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Huafen</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhou</LastName><ForeName>Jiali</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jiang</LastName><ForeName>Hong</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. Electronic address: hong-jiang@whu.edu.cn.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Infect</MedlineTA><NlmUniqueID>7908424</NlmUniqueID><ISSNLinking>0163-4453</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016019" MajorTopicYN="N">Survival Analysis</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Coronavirus infections</Keyword><Keyword MajorTopicYN="Y">Pneumonia</Keyword><Keyword MajorTopicYN="Y">Prognosis</Keyword><Keyword MajorTopicYN="Y">SARS-CoV-2</Keyword></KeywordList><CoiStatement>Declaration of Competing Interest The authors declare that there is no conflict of interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>03</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>03</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>4</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>5</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>4</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32240670</ArticleId><ArticleId IdType="pii">S0163-4453(20)30146-8</ArticleId><ArticleId IdType="doi">10.1016/j.jinf.2020.03.019</ArticleId><ArticleId IdType="pmc">PMC7118526</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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