Risk Factors for Mortality in 244 Older Adults With COVID-19 in Wuhan, China: A Retrospective Study

J Am Geriatr Soc. 2020 Jun;68(6):E19-E23. doi: 10.1111/jgs.16533. Epub 2020 May 12.


Background/objectives: Previous studies have reported that older patients may experience worse outcome(s) after infection with severe acute respiratory syndrome coronavirus-2 than younger individuals. This study aimed to identify potential risk factors for mortality in older patients with coronavirus disease 2019 (COVID-19) on admission, which may help identify those with poor prognosis at an early stage.

Design: Retrospective case-control.

Setting: Fever ward of Sino-French New City Branch of Tongji Hospital, Wuhan, China.

Participants: Patients aged 60 years or older with COVID-19 (n = 244) were included, of whom 123 were discharged and 121 died in hospital.

Measurements: Data retrieved from electronic medical records regarding symptoms, signs, and laboratory findings on admission, and final outcomes of all older patients with COVID-19, were retrospectively reviewed. Univariate and multivariate logistic regression analyses were used to explore risk factors for death.

Results: Univariate analysis revealed that several clinical characteristics and laboratory variables were significantly different (ie, P < .05) between discharged and deceased patients. Multivariable logistic regression analysis revealed that lymphocyte (LYM) count (odds ratio [OR] = 0.009; 95% confidence interval [CI] = 0.001-0.138; P = .001) and older age (OR = 1.122; 95% CI = 1.007-1.249; P = .037) were independently associated with hospital mortality. White blood cell count was also an important risk factor (P = .052). The area under the receiver operating characteristic curve in the logistic regression model was 0.913. Risk factors for in-hospital death were similar between older men and women.

Conclusion: Older age and lower LYM count on admission were associated with death in hospitalized COVID-19 patients. Stringent monitoring and early intervention are needed to reduce mortality in these patients. J Am Geriatr Soc 68:E19-E23, 2020.

Keywords: COVID-19; mortalityolder patientsrisk factors.

MeSH terms

  • Age Factors*
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • COVID-19
  • Case-Control Studies
  • China / epidemiology
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / virology
  • Female
  • Hospital Mortality
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Pandemics
  • Patient Admission / statistics & numerical data*
  • Patient Discharge / statistics & numerical data*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / virology
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2