BackgroundOutcomes of coronavirus disease 2019 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. MethodologyWe 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. ResultsOur 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. ConclusionsOur 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.

IntroductionCoronavirus disease 2019 (COVID-19) is a multisystemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can lead to a broad spectrum of disease severity, from asymptomatic to severe respiratory disease. In addition, the mortality rate is exceedingly high among COVID-19 patients admitted to the ICU. The purpose of this study is to examine the differences between survivors and non-survivors of critically ill COVID-19 patients admitted to the ICU. MethodThis multicenter retrospective observational study was conducted at two hospitals in Southern California, USA. First, we compared the characteristics of the ICU patients that died and those that survived using the chi-square test for categorical variables and t-test for the continuous variables, with a p-value of 0.05 considered significant. Finally, we did a backward selection Cox multivariate regression analysis using mortality as a dependent variable. ResultThere were 1,116 patients admitted with COVID-19 during our study period. Of this number, 238 (21.3%) were admitted to the ICU. Among patients admitted to the ICU, 195 (81.9%) died and 43 (18.1%) survived. In the multivariate Cox regression analysis, C-reactive protein (CRP) (HR 1.03, 95% CI 1.003-1.059), tachycardia (HR 3.51, 95% CI 1.83-6.72), and age (HR 1.02, 95% CI 1.01-1.04) were independently associated with mortality. Patients' BMI and comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, and chronic kidney disease did not predict mortality. ConclusionAge, elevated CRP, and tachycardia were independent risk factors for mortality in COVID-19 patients admitted to the ICU. It appears that several factors that predict severe diseases in COVID-19 patients, such as BMI and comorbidities, become less important once patients are admitted to the ICU.

Introduction: Myocardial injury, causing elevated troponin levels, have been associated with worse outcomes in coronavirus disease 2019 (COVID-19) disease patients. However, our anecdotal experience did not consistently reflect this pattern. Therefore, we evaluated the outcomes of COVID-19 patients with elevated troponin. Methods: This is a retrospective study of 1,024 COVID-19 patients admitted to two hospitals in Southern California in the United States. We categorized the troponin levels as normal (≤1× upper reference limit (URL)), mildly elevated (>1 to ≤3× URL), and severely elevated (>3× URL). We compared the characteristics of the three troponin groups using chi-square for categorical variables and one-way Anova for the continuous variables. Finally, backward selection Cox regression analysis was carried out using mortality as a dependent variable. Results: Of the COVID-19 1,024 patients included in the study, 944 (92%) had normal troponin, 45 (4.4%) had mild elevation, and 35 (3.4%) had a severe elevation in troponin levels. In the multivariate Cox regression analysis, troponin elevation in patients without ST-elevation on ECG was not independently associated with mortality (hazard ratio 0.92, 95% CI 0.64-1.3). Increased risk of death was independently associated with age as well as serum C-reactive protein and serum creatinine levels. Conclusion: Elevated troponins without ST-elevation on ECG on hospital admission were not independently associated with increased mortality in hospitalized COVID-19 patients. However, further research is needed to fully understand the absence of a relationship between troponin elevation and mortality in our study population.