Related Experiment Video
Updated: Jul 26, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Post-acute sequelae of COVID-19 in older persons: multi-organ complications and mortality
Eric Yuk Fai Wan1,2,3, Ran Zhang3, Sukriti Mathur3
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Insights
Older adults (aged ≥ 60) who contract coronavirus disease 2019 (COVID-19) face increased long-term risks for multi-organ complications and mortality. Monitoring for developing symptoms is recommended for this vulnerable population.
Area of Science:
- Gerontology
- Infectious Diseases
- Public Health
Background:
- Limited evidence exists on the long-term health consequences of coronavirus disease 2019 (COVID-19) in older populations.
- Understanding these risks is crucial for managing the health of individuals aged 60 and above post-infection.
Purpose of the Study:
- To evaluate the long-term associations between COVID-19 infection and multi-organ complications and mortality in older adults (≥ 60 years).
- To provide evidence for targeted monitoring and management strategies for elderly COVID-19 survivors.
Main Methods:
- A cohort study design was employed using data from the UK Biobank and Hong Kong electronic health records.
- Older adults diagnosed with COVID-19 were matched with controls without COVID-19 and followed for up to 28 months.
- Cox regression analysis was used to assess the risk of multi-organ outcomes and all-cause mortality.
Main Results:
- COVID-19 infection was significantly associated with increased risks of cardiovascular (e.g., stroke, heart failure), respiratory (e.g., interstitial lung disease), neuropsychiatric (e.g., seizure), and renal (e.g., acute kidney disease) complications.
- The hazard ratios for major cardiovascular disease ranged from 1.2 to 1.4, and for interstitial lung disease from 3.4 to 4.0 in the UKB and HK cohorts, respectively.
- A substantially higher risk of all-cause mortality was observed in older adults with COVID-19, with hazard ratios of 4.9 in the UKB and 2.5 in the HK cohort.
Conclusions:
- Coronavirus disease 2019 significantly increases the long-term risk of multi-organ complications and mortality in individuals aged 60 and older.
- Proactive monitoring for the development of these complications is recommended for elderly patients following COVID-19 infection.
Introduction:
Evidence on long-term associations between coronavirus disease 2019 (COVID-19) and risks of multi-organ complications and mortality in older population is limited. This study evaluates these associations.
Research Design And Methods:
The cohorts included patients aged ≥60 year diagnosed with COVID-19 infection (cases), between 16 March 2020 and 31 May 2021 from the UK Biobank; and between 01 April 2020 and 31 May 2022 from the electronic health records in Hong Kong. Each patient was randomly matched with individuals without COVID-19 infection based on year of birth and sex and were followed for up to 18 months until 31 August 2021 for UKB, and up to 28 months until 15 August 2022 for HK cohort. Patients with COVID-19 infection over 6 months after the date of last dose of vaccination and their corresponding controls were excluded from our study. Characteristics between cohorts were further adjusted with Inverse Probability Treatment Weighting. For evaluating long-term association of COVID-19 with multi-organ disease complications and mortality after 21-days of diagnosis, Cox regression was employed.
Result:
10,759 (UKB) and 165,259 (HK) older adults with COVID-19 infection with matched 291,077 (UKB) and 1,100,394 (HK) non-COVID-19-diagnosed older adults were recruited. Older adults with COVID-19 were associated with a significantly higher risk of cardiovascular outcomes [major cardiovascular disease (stroke, heart failure and coronary heart disease): hazard ratio(UKB): 1.4 (95% Confidence interval: 1.1,1.6), HK:1.2 (95% CI: 1.1,1.3)]; myocardial infarction: HR(UKB): 1.8 (95% CI: 1.3,2.4), HK:1.2 (95% CI: 1.0,1.4)]; respiratory outcomes [interstitial lung disease: HR(UKB: 3.4 (95% CI: 2.5,4.5), HK: 4.0 (95% CI: 1.3,12.8); chronic pulmonary disease: HR(UKB): 1.7 (95% CI: 1.3,2.2), HK:1.6 (95% CI: 1.3,2.1)]; neuropsychiatric outcomes [seizure: HR(UKB): 2.6 (95% CI: 1.7,4.1), HK: 1.6 (95% CI: 1.2,2.1)]; and renal outcomes [acute kidney disease: HR(UKB): 1.4 (95% CI: 1.1,1.6), HK:1.6 (95% CI: 1.3,2.1)]; and all-cause mortality [HR(UKB): 4.9 (95% CI: 4.4,5.4), HK:2.5 (95% CI: 2.5,2.6)].
Conclusion:
COVID-19 is associated with long-term risks of multi-organ complications in older adults (aged ≥ 60). Infected patients in this age-group may benefit from appropriate monitoring of signs/symptoms for developing these complications.
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:29Pneumonia II: Pathophysiology
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care