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Effect of Comorbidities on In-hospital COVID-19 Mortality across Age Groups: A Retrospective Cohort Study in Iran

Reza Sadeghi1, Mahmood Reza Masoudi2, Mohammad Moqaddasi Amiri1

  • 1Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran.

Medical Journal of the Islamic Republic of Iran
|July 28, 2026
PubMed

Insights

Comorbidities significantly increase COVID-19 mortality risk, especially in adults aged 30-60. The number of underlying health conditions impacts death rates, but this effect varies by age group.

Area of Science:

  • Public Health
  • Epidemiology
  • Internal Medicine

Background:

  • COVID-19 poses a significant global health challenge, with higher mortality rates observed in older adults and those with comorbidities.
  • Previous studies have explored the impact of comorbidities on COVID-19 mortality, but not specifically across different age demographics.

Purpose of the Study:

  • To evaluate the influence of comorbidities on COVID-19 mortality across three distinct age groups.
  • To determine if the number of comorbidities affects mortality rates in COVID-19 patients and if this association differs by age.

Main Methods:

  • A retrospective study included 10,496 hospitalized COVID-19 patients with positive PCR results.
  • Data on underlying conditions (diabetes, hypertension, cardiovascular disease, chronic kidney disease), age, sex, and mortality were collected.
  • Chi-square tests and logistic regression analyses were used to assess the impact of comorbidities on mortality across age groups.

Main Results:

  • 19.4% of patients had at least one comorbidity, and 4.4% died from COVID-19. Of those who died, 197 had comorbidities.
  • Hypertension and diabetes were the most common comorbidities.
  • Comorbidities were significantly associated with increased COVID-19 mortality in the overall population (OR=3.26) and in the 30-60 (OR=2.63) and over 60 (OR=1.58) age groups.
  • The number of comorbidities also significantly increased mortality risk (OR=1.65 for two, OR=1.97 for three or more vs. one comorbidity), but this trend did not vary significantly across age groups.

Conclusions:

  • Comorbidities significantly influence COVID-19 mortality, particularly in individuals aged 30 and above, with a notable impact in the 30-60 age bracket.
  • While multiple comorbidities increase overall mortality risk, this specific association was not statistically significant when analyzed independently within each age group.
Abstract

Keywords:
Age GroupsCOVID-19 MortalityComorbiditiesRisk of MortalityUnderlying Disease

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