A comparative clinical features of COVID-19 in Non-elderly adult and elderly populations of Kermanshah province in Iran: a retrospective study.

Abstract

Introduction: COVID-19, caused by the SARS-CoV-2, emerged as a lethal infectious disease with viral pneumonia-like symptoms, and was first identified in Wuhan, China, in December 2019. This study aimed to compare the epidemiological characteristics and clinical manifestations of COVID-19 between elderly and non-elderly adult populations in Kermanshah Province, Iran.

Methods: This retrospective study included 20,943 COVID-19 patients diagnosed between March 2020 and July 2021. Data were collected from the Medical Care Monitoring Center (MCMC) and comprised demographic information, comorbidities, clinical symptoms, hospitalization duration, and outcomes (discharge or mortality). Statistical analyses were performed using chi-square tests, Kaplan-Meier survival analysis, and multivariate Cox regression.

Results: Of the 20,943 patients, 7,174 (34.3%) were aged 65 years or older. Elderly patients exhibited a higher prevalence of comorbidities such as diabetes (11.5% vs. 6.5%), heart disease (11.7% vs. 3.6%), and COPD (1.8% vs. 0.7%) compared to younger adults (P < 0.001). Additionally, elderly patients had a significantly higher mortality rate (19.4% vs. 6.0%) and shorter median survival time (18 days vs. 36 days) (P < 0.001). Severe symptoms, including hypoxemia (SpO2 < 93%) and altered mental status, were also more common in the elderly.

Conclusion: This study showed that elderly COVID-19 patients are at a higher risk of severe illness and mortality compared to younger adults. The presence of comorbidities and more severe clinical manifestations in this age group led to increased hospitalization duration and mortality. These findings underscore the importance of targeted clinical management and public health policies for the elderly population in the context of COVID-19.