Learning from Regional Variations in Clinical Profile and Outcomes among Hospitalized Elderly COVID-19 Patients: A Retrospective Study in South India

Abstract Background: While older adults are at greater risk of severe COVID-19 and mortality, the mortality rate among the elderly in India was lower than that reported in other countries, warranting further investigation into age-specific clinical characteristics and outcomes. Materials and Methods: A retrospective study was conducted on all reverse transcriptase polymerase chain reaction -confirmed COVID-19 patients admitted between July 2020 and March 2021 using data extracted from case records and the hospital COVID-19 registry. Patients were classified into two age groups: elderly (≥60 years) and younger (<60 years). Descriptive statistics and adjusted logistic regression were used to compare clinical features and predictors of mortality. Results: Among 7256 patients, 20% were aged 60 years or older. While almost one in two elderly patients were asymptomatic, among the rest, one in three experienced respiratory distress; the mortality rate was five times higher than in younger cohorts; and neither diabetes nor hypertension was independently associated with mortality. The in-hospital mortality rate in the elderly was 10.8%, five times higher than in younger patients (2.3%). Respiratory distress was the only symptom independently associated with death (odds ratio 5.1, 95% confidence interval 2.3–11.1). Among those with baseline lab data ( n = 570), common abnormalities included hypoalbuminemia (88%), anemia (70%), high neutrophil-lymphocyte ratio (62.9%), hyperglycemia (62.4%), hyperkalemia (48.4%), and elevated blood urea nitrogen (45.4%). Conclusion: Elderly COVID-19 patients in India exhibit a distinct clinical profile. These findings support the need for age and region-sensitive care strategies during health emergencies.