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Analysis of Influencing Factors of Death in the Elderly With Coronavirus Disease 2019 Based on Propensity Score

Ying Chen1, Hai-Ping Huang1, Xin Li1

  • 1Department of Epidemiology and Health Statistics,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu 610041,China.

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
|July 24, 2025
PubMed

Insights

Elderly individuals with COVID-19 face increased death risks from smoking, stroke, tumors, heart disease, breathing difficulties, and vomiting. Fever, however, showed a protective effect in this vulnerable population.

Area of Science:

  • Gerontology
  • Infectious Diseases
  • Epidemiology

Background:

  • Coronavirus disease 2019 (COVID-19) poses a significant threat to the elderly population.
  • Understanding mortality risk factors in elderly COVID-19 patients is crucial for targeted interventions.

Purpose of the Study:

  • To identify and analyze the key factors influencing mortality among elderly patients diagnosed with COVID-19.
  • To develop a predictive model for COVID-19 death risk in the elderly population.

Main Methods:

  • Retrospective case-control study analyzing data from West China Fourth Hospital (January 1 to July 8, 2023).
  • Propensity score matching was used to compare deceased COVID-19 patients with survivors from the West China Elderly Health Cohort.
  • LASSO-Logistic regression analysis was employed to identify significant risk factors, with model validity assessed by ROC curve.

Main Results:

  • The study included 3,239 COVID-19 survivors and 142 deaths.
  • Significant risk factors for mortality included smoking (OR=3.33), stroke (OR=3.55), malignant tumors (OR=19.93), coronary heart disease (OR=7.68), difficulty breathing/asthma (OR=21.48), and vomiting (OR=8.19).
  • Fever (OR=0.51) was associated with a reduced risk of death. The predictive model achieved an AUC of 0.889.

Conclusions:

  • Smoking, stroke, malignant tumors, coronary heart disease, breathing difficulties, and vomiting are critical determinants of mortality in elderly COVID-19 patients.
  • Fever may indicate a different disease trajectory or host response in some elderly COVID-19 cases.
  • These findings underscore the need for proactive management of comorbidities and symptoms in elderly COVID-19 patients to mitigate mortality risk.

Keywords:
LASSO regressioncoronavirus disease 2019influencing factorpropensity score matching

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