Comparison of Clinical Characteristics and Outcomes of COVID-19 Between Young and Older Patients: A Multicenter, Retrospective Cohort Study

Abstract

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.

Role of leukocytes and systemic inflammation indexes (NLR, PLR, MLP, dNLR, NLPR, AISI, SIR-I, and SII) on admission predicts in-hospital mortality in non-elderly and elderly COVID-19 patients

“…Symptoms of coronavirus disease 2019 (COVID- 19) in patients are reported to vary from minor symptoms (such as headache, fatigue, and fever) to severe symptoms (such as dyspnea or hypoxia) (1)(2)(3)(4). With this wide range of clinical characteristics and disease outcomes, differences between nonelderly and old patients have also been reported (1,(5)(6)(7). Various studies have shown that old age is associated with high disease severity and mortality (8).…”

Clinical Characteristics and Implications of Bradycardia in COVID-19 Patients Treated with Remdesivir: A Single-Center Retrospective Cohort Study

“…RAB+ patients were found to be associated with a greater propensity for inpatient mortality, elevated inflammatory markers such as D-dimer, and higher rates of invasive mechanical ventilation ( p = 0.008), suggesting that EBs amongst RAB+ patients may be related to the severity of illness. Furthermore, the incidence of EBs amongst patients receiving remdesivir appeared to be higher compared to rates of bradycardia in studies of patients with COVID-19 in the literature [ 25 , 26 , 31 , 32 ]. Further comparative studies are needed to tease out the exact etiology of RAB.…”

“…Although previous COVID-19 studies have found associations between bradycardia and mortality [ 25 , 26 , 31 , 32 ], the literature is conflicting. Several cases have observed RAB followed by a return to normal HR range following withdrawal of remdesivir therapy [ 33 , 34 ].…”

“…No differences in mortality or intensive care admission rate were found, although the limited sample size may have restricted the analysis. Another large multicenter investigation did not find a significant relationship between remdesivir and bradycardia [ 32 ]. In both studies, bradycardic episodes were measured throughout the entirety of a patient’s hospital course, which may introduce a confounding effect.…”

Prognostic value of the neutrophil-to-lymphocyte ratio and C-reactive-protein-to-prealbumin ratio in hospitalized older patients with coronavirus disease 2019

“…[1] Compared to younger people, older people are more likely to experience severe symptoms of COVID-19 due to decreased immune system function, chronic diseases, and organ dysfunction. [10–12] However, there was no significant difference between the deceased and surviving subgroups, possibly because they were older than the patients in the non-severe group. Indeed, there is evidence that men are significantly more likely to develop COVID-19 than women.…”