AUTHOR=Zhang Han , Wu Yingying , He Yuqing , Liu Xingyuan , Liu Mingqian , Tang Yuhong , Li Xiaohua , Yang Guang , Liang Gang , Xu Shabei , Wang Minghuan , Wang Wei 

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

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.757459

DOI=10.3389/fmed.2021.757459

ISSN=2296-858X

ABSTRACT=<p><bold>Objective:</bold> To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [<italic>OR</italic>] = 1.061 [95% <italic>CI</italic> 1.057–1.065], <italic>p</italic> &lt; 0.001), male gender (<italic>OR</italic> = 1.726 [95% <italic>CI</italic> 1.582–1.885], <italic>p</italic> &lt; 0.001), alcohol consumption (<italic>OR</italic> = 1.558 [95% <italic>CI</italic> 1.355–1.786], <italic>p</italic> &lt; 0.001), smoking (<italic>OR</italic> = 1.326 [95% <italic>CI</italic> 1.055–1.652], <italic>p</italic> = 0.014), hypertension (<italic>OR</italic> = 1.175 [95% <italic>CI</italic> 1.067–1.293], <italic>p</italic> = 0.001), diabetes (<italic>OR</italic> = 1.258 [95% <italic>CI</italic> 1.118–1.413], <italic>p</italic> &lt; 0.001), cancer (<italic>OR</italic> = 1.86 [95% <italic>CI</italic> 1.507–2.279], <italic>p</italic> &lt; 0.001), chronic kidney disease (CKD) (<italic>OR</italic> = 1.745 [95% <italic>CI</italic> 1.427–2.12], <italic>p</italic> &lt; 0.001), and intracerebral hemorrhage (ICH) (<italic>OR</italic> = 1.96 [95% <italic>CI</italic> 1.323–2.846], <italic>p</italic> = 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 &lt;40 years, only cancer (<italic>OR</italic> = 17.112 [95% <italic>CI</italic> 6.264–39.73], <italic>p</italic> &lt; 0.001) and ICH (<italic>OR</italic> = 31.538 [95% <italic>CI</italic> 5.213–158.787], <italic>p</italic> &lt; 0.001) were significantly associated with higher odds of death. For patients aged &gt;80 years, only age (<italic>OR</italic> = 1.033 [95% <italic>CI</italic> 1.008–1.059], <italic>p</italic> = 0.01) and male gender (<italic>OR</italic> = 1.585 [95% <italic>CI</italic> 1.301–1.933], <italic>p</italic> &lt; 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 (<italic>p</italic> = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.</p><p><bold>Conclusions:</bold> 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.</p>