Predictors of severe COVID-19: older age and comorbidity

BACKGROUND: Older age and comorbidity are recognized as significant risk factors for severe COVID-19. However, the combined impact of these factors on disease outcomes, especially in different age groups, remains unclear. This study focuses on older patients with chronic comorbidities in order to address this gap.

AIM: This study aimed to evaluate the role of older age and comorbidities in prediction of severe COVID-19 and mortality in hospitalized patients.

METHODS: This cross-sectional, retrospective study included 604 patients aged 18–99 years who were treated at Infectious Diseases Clinical Hospital No. 2 of the Moscow Healthcare Department for laboratory-confirmed (ICD-10 code: U07.1) COVID-19 between September 2020 and November 2022. Demographic characteristics, comorbidities, clinical outcomes (recovery, improvement, and mortality rates), and COVID-19 severity were evaluated.

RESULTS: An analysis of 604 hospitalized patients revealed an increase in mortality rates with age: 4.1% in patients under 60 years old, 12.7% in patients aged 60–74 years, 16.4% in patients aged 75–89 years, and 21.9% in patients aged 90 years and older. The most common comorbidity-associated risk factors included chronic kidney disease (mortality rate: 23.2%), myocardial ischemia (19.7%), and type 2 diabetes mellitus (18%). The infection was atypical, without fever in 21% of patients, primarily those in the older age group. Stratified analysis showed that the role of specific risk factors, such as chemotherapy, myocardial ischemia, and chronic kidney disease, varied across age groups.

CONCLUSION: Older age and comorbidities are independent risk factors for severe COVID-19 and fatal outcomes. Patients over the age of 75 years with chronic diseases require special attention. Early diagnosis and personalized management strategies may improve outcomes in this age group.