Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients

BackgroundThis study aims to compare the differences in mortality and related factors between old-old and young-old COVID-19 patients and find unique factors related to survival in old-old patients.Study designSingle-center retrospective cohort study following STROBE guidelines.MethodsWe included 30...

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Main Authors: Linyi Zhong, Linlin Huang, Mengchen Zhang, Congcong Tian, Lijuan Zhang, Guobin Song
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1608667/full
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author Linyi Zhong
Linyi Zhong
Linlin Huang
Mengchen Zhang
Congcong Tian
Lijuan Zhang
Guobin Song
author_facet Linyi Zhong
Linyi Zhong
Linlin Huang
Mengchen Zhang
Congcong Tian
Lijuan Zhang
Guobin Song
author_sort Linyi Zhong
collection DOAJ
description BackgroundThis study aims to compare the differences in mortality and related factors between old-old and young-old COVID-19 patients and find unique factors related to survival in old-old patients.Study designSingle-center retrospective cohort study following STROBE guidelines.MethodsWe included 302 elderly (≥65 years old) COVID-19 patients admitted to Shijiazhuang People’s Hospital from December 1, 2022 to March 31, 2023. Among them, 142 were assigned to the young-old group (65–74 years old) and 160 in the old-old group (≥75 years old). Demographic, clinical and laboratory data were extracted, and descriptive statistical analysis, comparison of differences between groups, Cox proportional hazards regression analysis, and subgroup analysis were adopted.ResultsCompared with the young-old group, the mortality of old-old patients was higher (31.3% vs. 12.7%, p < 0.001). Risk factors associated with mortality specifically in old-old patients include dyspnea (HR: 2.829, 95%CI: 1.571–5.093), acute cardiac injury (HR: 2.403, 95%CI: 1.369–4.219), and diabetes (HR: 2.401, 95%CI: 1.311–4.397), glucocorticoid therapy (HR: 2.397, 95%CI: 1.198–4.798). Moreover, there was a significant difference in the survival curves between the young-old and the old-old group (p = 0.0001). However, no significant sex differences in mortality and survival curves were found in either group.ConclusionThis study found for the first time that dyspnea symptoms, acute heart injury, diabetes, and glucocorticoid therapy are unique risk factors related to survival in old-old patients with COVID-19. These factors need more attention when treating old-old patients to prevent poor prognosis.
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spelling doaj-art-bbfd4fbb921f4ff198efc7ff9c527ab52025-08-20T03:09:35ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16086671608667Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patientsLinyi Zhong0Linyi Zhong1Linlin Huang2Mengchen Zhang3Congcong Tian4Lijuan Zhang5Guobin Song6Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of General Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, ChinaDepartment of General Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, ChinaDepartment of General Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, ChinaDepartment of General Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, ChinaDepartment of General Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, ChinaDepartment of General Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, ChinaBackgroundThis study aims to compare the differences in mortality and related factors between old-old and young-old COVID-19 patients and find unique factors related to survival in old-old patients.Study designSingle-center retrospective cohort study following STROBE guidelines.MethodsWe included 302 elderly (≥65 years old) COVID-19 patients admitted to Shijiazhuang People’s Hospital from December 1, 2022 to March 31, 2023. Among them, 142 were assigned to the young-old group (65–74 years old) and 160 in the old-old group (≥75 years old). Demographic, clinical and laboratory data were extracted, and descriptive statistical analysis, comparison of differences between groups, Cox proportional hazards regression analysis, and subgroup analysis were adopted.ResultsCompared with the young-old group, the mortality of old-old patients was higher (31.3% vs. 12.7%, p < 0.001). Risk factors associated with mortality specifically in old-old patients include dyspnea (HR: 2.829, 95%CI: 1.571–5.093), acute cardiac injury (HR: 2.403, 95%CI: 1.369–4.219), and diabetes (HR: 2.401, 95%CI: 1.311–4.397), glucocorticoid therapy (HR: 2.397, 95%CI: 1.198–4.798). Moreover, there was a significant difference in the survival curves between the young-old and the old-old group (p = 0.0001). However, no significant sex differences in mortality and survival curves were found in either group.ConclusionThis study found for the first time that dyspnea symptoms, acute heart injury, diabetes, and glucocorticoid therapy are unique risk factors related to survival in old-old patients with COVID-19. These factors need more attention when treating old-old patients to prevent poor prognosis.https://www.frontiersin.org/articles/10.3389/fmed.2025.1608667/fullCOVID-19older adultsmortalityrisk factorsretrospective study
spellingShingle Linyi Zhong
Linyi Zhong
Linlin Huang
Mengchen Zhang
Congcong Tian
Lijuan Zhang
Guobin Song
Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients
Frontiers in Medicine
COVID-19
older adults
mortality
risk factors
retrospective study
title Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients
title_full Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients
title_fullStr Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients
title_full_unstemmed Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients
title_short Exploring the differences in mortality and its associated factors among young-old and old-old COVID-19 patients
title_sort exploring the differences in mortality and its associated factors among young old and old old covid 19 patients
topic COVID-19
older adults
mortality
risk factors
retrospective study
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1608667/full
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