Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study
Han Zhang, Yingying Wu, Yuqing He, Xingyuan Liu, Mingqian Liu, Yuhong Tang, Xiaohua Li, Guang Yang, Gang Liang, Shabei Xu, Minghuan Wang, Wei Wang
Abstract
Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19). Methods: 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. Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [ OR ] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender ( OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption ( OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking ( OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension ( OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes ( OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer ( OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) ( OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) ( OR = 1.96 [95% CI 1.323–2.846], p = 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 ( OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH ( OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age ( OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender ( OR = 1.585 [95% CI 1.301–1.933], p < 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 ( p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications. Conclusions: 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.