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Published on: March 22, 2022
Comparison of Clinical Characteristics and Outcomes of COVID-19 Between Young and Older Patients: A Multicenter,
Chukwuemeka Umeh1, Kimberly Watanabe1, Laura Tuscher1
1Internal Medicine, Hemet Global Medical Center, Hemet, USA.
Insights
COVID-19 outcomes vary by age. This study found age, C-reactive protein (CRP), and bradycardia predict mortality in younger patients, while only CRP predicts mortality in older patients.
Area of Science:
- Epidemiology
- Infectious Diseases
- Gerontology
Background:
- COVID-19 outcomes differ between young and elderly populations.
- Previous studies had small sample sizes, limiting insights into age-related differences.
- A large multicenter dataset is needed to accurately assess these disparities.
Purpose of the Study:
- To evaluate differences in COVID-19 outcomes between young and elderly patients.
- To identify age-specific predictors of mortality in COVID-19.
- To utilize a large multicenter dataset for robust analysis.
Main Methods:
- Retrospective study of 1,116 COVID-19 patients (March 2020-March 2021).
- Patients categorized into two groups: <65 years and ≥65 years.
- Kaplan-Meier and Cox multivariate regression analyses performed for mortality prediction.
Main Results:
- Patients <65 years showed increased survival compared to those ≥65 years (p < 0.001).
- In patients ≥65 years, age, C-reactive protein (CRP), and bradycardia predicted mortality.
- In patients <65 years, CRP predicted mortality, and being male was protective (HR = 0.46, p = 0.002).
Conclusions:
- Mortality predictors in COVID-19 patients differ significantly by age group.
- Age, CRP, and bradycardia are key mortality predictors in younger COVID-19 patients.
- CRP is the primary mortality predictor in older COVID-19 patients, with male sex showing a protective effect in younger individuals.
Abstract:
Background Outcomes of coronavirus disease 2019 (COVID-19) have been reported to be different in the young and elderly populations. However, previous studies examining these characteristics and differences in outcomes between the two groups had a small sample size. Therefore, in this study, we evaluate the differences between young and elderly patients using a large multicenter dataset. Methodology We conducted a retrospective study of 1,116 consecutive COVID-19 patients admitted to two hospitals in southern California in the United States between March 2020 and March 2021. In this study, we categorized patients into two age groups: less than 65 years and 65 years and above. Finally, Kaplan-Meier and backward selection Cox multivariate regression analyses were done using mortality as the dependent variable. Results Our analysis showed increased survival in patients aged less than 65 years compared to those aged 65 years or above (p < 0.001). Furthermore, in patients aged 65 years and above, age (hazard ratio (HR) = 1.05; p < 0.001), C-reactive protein (CRP) (HR = 1.05; p < 0.001), and bradycardia (HR = 2.1; p < 0.001) were significantly associated with mortality. Similarly, CRP (HR 1.05; p = 0.02) was significantly associated with mortality in patients aged less than 65 years. However, contrary to many studies, being male (HR = 0.46; p = 0.002) was protective against mortality in patients aged less than 65 years. Conclusions Our study showed that the predictors of mortality in COVID-19 patients differed by age group. While age, CRP, and bradycardia were associated with mortality in those aged less than 65 years, only CRP was associated with mortality in those aged 65 years and above.
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