ORIGINAL RESEARCH article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1608667
Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients
Provisionally accepted
- 1Shijiazhuang People’s Hospital, Shijiazhuang, China
- 2Hebei Medical University, Shijiazhuang, Hebei Province, China
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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. Conclusions 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. Keywords: COVID-19; Older adults; Mortality; Risk factors; Retrospective study
Keywords: COVID-19, older adults, Mortality, Risk factors, Retrospective study
Received: 09 Apr 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Zhang, Zhong, Huang, Zhang, Tian and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lijuan Zhang, Shijiazhuang People’s Hospital, Shijiazhuang, China
Guobin Song, Shijiazhuang People’s Hospital, Shijiazhuang, China
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