Clinical characteristics between older and younger patients with COVID-19 infection in a tertiary hospital: a retrospective cross-sectional study

Abstract

Objective. This study aims to compare older and younger patients with COVID-19 infection in terms of patient characteristics, presenting symptoms, laboratory parameters, complications, treatment received, and outcomes.Methods. Medical records of patients aged ≥12 years who were admitted to Hospital Tengku Ampuan Rahimah between 1 January 2021 and 31 June 2021 with polymerase chain reaction-proven COVID-19 infection were retrospectively reviewed. Data collected included sociodemographic data (age, ethnicity, sex, and residence), comorbidities, COVID-19 presentation (acute presenting symptoms, primary working diagnosis, disease severity, laboratory parameters on admission, and treatment received), and outcomes (complications, length of hospital stay, discharge destination, oxygen support required, and mortality).Results. A total of 259 patients aged 18 to 91 years were admitted to our hospital with COVID-19 infection. Of them, 182 (70.3%) were younger patients and 77 (29.7%) were older patients (aged >60 years). More older patients than younger patients had comorbidities (87.0% vs 49.5%, p<0.001) and presented with delirium (13% vs 0.5%, p<0.001) and lethargy (33.8% vs 15.9%, p=0.001). More older patients had severe COVID-19 infection (72.7% vs 38.5%, p<0.001), with 9.1% necessitating intubation. More older patients were prescribed favipiravir (64.9% vs 32.4%, p<0.001), antibiotics (76.6% vs 44%, p<0.001), and steroid (75.3% vs 40.1%, p<0.001). More older patients required intensive care (32.5% vs 17%, p=0.003). More older patients developed complications such as secondary infection (41.6% vs 17%, p<0.001) and acute kidney injury necessitating dialysis (20.8% vs 8.8%, p=0.005). Older patients had longer length of hospital stay (14 vs 12 days, p<0.001) and higher mortality (18.2% vs 4.4%, p<0.001). Conclusion.Older patients with COVID-19 infection tend to have more severe disease, higher complication rate, and higher mortality. Timely management is essential to minimise morbidity and mortality.