Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study.

Objective

To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).

Methods

In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.

Results

There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057-1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582-1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355-1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055-1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067-1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118-1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507-2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427-2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323-2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40-80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264-39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213-158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008-1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301-1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.

Conclusions

Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.