Clinical characteristics between older and younger patients with COVID-19 infection in a tertiary hospital: a retrospective cross-sectional study

Objective. This study aims to compare older and younger patients with COVID-19 infection in terms of patient characteristics, presenting symptoms, laboratory parameters, complications, treatment received, and outcomes. Methods. Medical records of patients aged >12 years who were admitted to Hospital Tengku Ampuan Rahimah between 1 January 2021 and 31 June 2021 with polymerase chain reaction-proven COVID-19 infection were retrospectively reviewed. Data collected included sociodemographic data (age, ethnicity, sex, and residence), comorbidities, COVID-19 presentation (acute presenting symptoms, primary working diagnosis, disease severity, laboratory parameters on admission, and treatment received), and outcomes (complications, length of hospital stay, discharge destination, oxygen support required, and mortality). Results. A total of 259 patients aged 18 to 91 years were admitted to our hospital with COVID-19 infection. Of them, 182 (70.3%) were younger patients and 77 (29.7%) were older patients (aged >60 years). More older patients than younger patients had comorbidities (87.0% vs 49.5%, p<0.001) and presented with delirium (13% vs 0.5%, p<0.001) and lethargy (33.8% vs 15.9%, p=0.001). More older patients had severe COVID-19 infection (72.7% vs 38.5%, p<0.001), with 9.1% necessitating intubation. More older patients were prescribed favipiravir (64.9% vs 32.4%, p<0.001), antibiotics (76.6% vs 44%, p<0.001), and steroid (75.3% vs 40.1%, p<0.001). More older patients required intensive care (32.5% vs 17%, p=0.003). More older patients developed complications such as secondary infection (41.6% vs 17%, p<0.001) and acute kidney injury necessitating dialysis (20.8% vs 8.8%, p=0.005). Older patients had longer length of hospital stay (14 vs 12 days, p<0.001) and higher mortality (18.2% vs 4.4%, p<0.001). Conclusion. Older patients with COVID-19 infection tend to have more severe disease, higher complication rate, and higher mortality. Timely management is essential to minimise morbidity and mortality.