Abstract
BACKGROUND: This study aims to compare the differences in mortality and related factors between old-old and young-old COVID-19 patients and find unique factors related to survival in old-old patients. STUDY DESIGN: Single-center retrospective cohort study following STROBE guidelines. METHODS: We included 302 elderly (≥65 years old) COVID-19 patients admitted to Shijiazhuang People's Hospital from December 1, 2022 to March 31, 2023. Among them, 142 were assigned to the young-old group (65-74 years old) and 160 in the old-old group (≥75 years old). Demographic, clinical and laboratory data were extracted, and descriptive statistical analysis, comparison of differences between groups, Cox proportional hazards regression analysis, and subgroup analysis were adopted. RESULTS: Compared with the young-old group, the mortality of old-old patients was higher (31.3% vs. 12.7%, p < 0.001). Risk factors associated with mortality specifically in old-old patients include dyspnea (HR: 2.829, 95%CI: 1.571-5.093), acute cardiac injury (HR: 2.403, 95%CI: 1.369-4.219), and diabetes (HR: 2.401, 95%CI: 1.311-4.397), glucocorticoid therapy (HR: 2.397, 95%CI: 1.198-4.798). Moreover, there was a significant difference in the survival curves between the young-old and the old-old group (p = 0.0001). However, no significant sex differences in mortality and survival curves were found in either group. CONCLUSION: This study found for the first time that dyspnea symptoms, acute heart injury, diabetes, and glucocorticoid therapy are unique risk factors related to survival in old-old patients with COVID-19. These factors need more attention when treating old-old patients to prevent poor prognosis.