Aging
Navigate
Submit an Article
Research Paper|Volume 13, Issue 1|pp 27—60

Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study

Guangdi Li1,2, Yacong Liu2, Xixi Jing2, Yali Wang2, Miao Miao2, Li Tao3, Zhiguo Zhou4, Yuanlin Xie5, Yaxiong Huang4, Jianhua Lei1, Guozhong Gong1, Ping Jin6, Yuantao Hao7, Nuno Rodrigues Faria8,9, Erik De Clercq10, Min Zhang1
  • 1Institute of Hepatology and Department of Infectious Diseases, The Second Xiangya Hospital, Central South University, Changsha, China
  • 2Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
  • 3School of Mathematics and Statistics, Central South University, Changsha, China
  • 4The First Hospital of Changsha, Changsha, China
  • 5The Fourth Hospital of Changsha, Changsha, China
  • 6Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, China
  • 7Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
  • 8Department of Zoology, University of Oxford, Oxford, UK
  • 9Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
  • 10Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
Received: July 30, 2020Accepted: December 9, 2020Published: December 31, 2020
https://doi.org/10.18632/aging.202456

Copyright: © 2020 Wen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The COVID-19 pandemic causes severe morbidity and mortality. This multi-country study aimed to explore risk factors that drive mortality in COVID-19 patients who received neither dexamethasone nor remdesivir. We analyzed a cohort of 568 survivors and 507 non-survivors from China, European regions, and North America. Elderly males ≥70 years accounted for only 25% of survivors, but this rate was significantly higher in non-survivors from China (55%), European regions (63%), and North America (47%). Compared with survivors, non-survivors had more incidences of comorbidities such as cerebrovascular disease and chronic obstructive pulmonary disease (COPD, p-values<0.05). Survival analyses revealed age, male gender, shortness of breath, cerebrovascular disease, and COPD as mortality-associated factors. Survival time from symptom onset was significantly shorter in elderly versus young patients (median: 29 versus 62 days), males versus females (median: 46 versus 59 days), and patients with versus without comorbidities (mean: 41 versus 61 days). Mortality risk was higher in elderly males with comorbidities than in young females without comorbidities (p-value<0.01). Elderly male survivors with comorbidities also had longer hospital stays than other survivors (25 versus 18.5 days, p-value<0.01). Overall, the high mortality risk in elderly males with COVID-19-associated comorbidities supports early prevention and critical care for elderly populations.