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

Abstract

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