Zhong Linyi, Huang Linlin, Zhang Mengchen, Tian Congcong, Zhang Lijuan, Song Guobin
Hebei Medical University, Shijiazhuang, Hebei, China.
Department of General Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, China.
Front Med (Lausanne). 2025 Jul 30;12:1608667. doi: 10.3389/fmed.2025.1608667. eCollection 2025.
This 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.
Single-center retrospective cohort study following STROBE guidelines.
We 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.
Compared with the young-old group, the mortality of old-old patients was higher (31.3% vs. 12.7%, < 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 ( = 0.0001). However, no significant sex differences in mortality and survival curves were found in either group.
This 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.
本研究旨在比较高龄与低龄新冠病毒肺炎（COVID-19）患者的死亡率及相关因素差异，并找出与高龄患者生存相关的独特因素。
遵循STROBE指南的单中心回顾性队列研究。
纳入2022年12月1日至2023年3月31日在石家庄市人民医院住院的302例年龄≥65岁的COVID-19老年患者。其中，142例被分配至低龄组（65 - 74岁），160例被分配至高龄组（≥75岁）。提取人口统计学、临床和实验室数据，并采用描述性统计分析、组间差异比较、Cox比例风险回归分析和亚组分析。
与低龄组相比，高龄患者的死亡率更高（31.3%对12.7%，<0.001）。高龄患者死亡的危险因素包括呼吸困难（HR：2.829，95%CI：1.571 - 5.093）、急性心脏损伤（HR：2.403，95%CI：1.369 - 4.219）、糖尿病（HR：2.401，95%CI：1.311 - 4.397）、糖皮质激素治疗（HR：2.397，95%CI：1.198 - 4.798）。此外，低龄组和高龄组的生存曲线存在显著差异（=0.0001）。然而，两组在死亡率和生存曲线上均未发现显著的性别差异。
本研究首次发现呼吸困难症状、急性心脏损伤、糖尿病和糖皮质激素治疗是高龄COVID-19患者生存的独特危险因素。在治疗高龄患者时，这些因素需要更多关注以预防不良预后。
