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Background <p>Coronavirus disease 2019 (COVID-19) has significantly increased mortality worldwide, with advanced age and comorbidity burden has been identified as a major risk factors. However, the combined effect of age and comorbidity burden on COVID-19 mortality remains unclear. This study aimed to assess the independent and interactive effects of age and comorbidity burden on in-hospital mortality from COVID-19.</p> Methods <p>A retrospective cohort study was conducted among 642 laboratory-confirmed COVID-19 patients admitted to a tertiary care hospital in Belagavi, Karnataka, India, between October 2020 and September 2021. Bivariate analysis, multivariable logistic regression, and interaction analysis were performed to examine associations with mortality.</p> Results <p>Patients aged ≥ 50 years had significantly higher odds of mortality compared to those aged &lt; 50 years (AOR = 2.01, 95% CI: 1.27–3.16, <i>p</i> = 0.002). Dyspnea (AOR = 2.88, 95% CI: 1.85–4.48, <i>p</i> &lt; 0.001) and kidney disease (AOR = 6.56, 95% CI: 2.39–18.02, <i>p</i> &lt; 0.001) were significant predictors of mortality. Blood glucose (per 10&#xa0;mg/dL increase; AOR = 1.03, 95% CI: 1.01–1.05, <i>p</i> &lt; 0.001) and pulse rate (per bpm increase; AOR = 1.02, 95% CI: 1.01–1.03, <i>p</i> &lt; 0.001) were also significantly associated with mortality. Multimorbidity was not independently associated with mortality in the main model (AOR = 1.63, 95% CI: 0.67–4.00, <i>p</i> = 0.278). In the interaction model, no statistically significant interaction between age and multimorbidity was observed. However, predicted probabilities suggested a higher mortality risk among older patients with multimorbidity compared to other groups.</p> Conclusion <p>Advanced age, dyspnea, kidney disease, elevated blood glucose, and pulse rate are significant predictors of COVID-19 mortality. While multimorbidity may contribute to mortality risk, no strong evidence of interaction between age and comorbidity burden was observed. These findings highlight the importance of comprehensive risk stratification using multiple clinical factors in hospitalized COVID-19 patients.</p> Clinical trial <p>Not applicable.</p>

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Age and comorbidity in COVID-19 mortality: a retrospective cohort study using multivariable regression and interaction analyses

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月5日

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  • Nuha Al-Aghbari,
  • Arif Maldar,
  • Mubashir Angolkar

摘要

Background

Coronavirus disease 2019 (COVID-19) has significantly increased mortality worldwide, with advanced age and comorbidity burden has been identified as a major risk factors. However, the combined effect of age and comorbidity burden on COVID-19 mortality remains unclear. This study aimed to assess the independent and interactive effects of age and comorbidity burden on in-hospital mortality from COVID-19.

Methods

A retrospective cohort study was conducted among 642 laboratory-confirmed COVID-19 patients admitted to a tertiary care hospital in Belagavi, Karnataka, India, between October 2020 and September 2021. Bivariate analysis, multivariable logistic regression, and interaction analysis were performed to examine associations with mortality.

Results

Patients aged ≥ 50 years had significantly higher odds of mortality compared to those aged < 50 years (AOR = 2.01, 95% CI: 1.27–3.16, p = 0.002). Dyspnea (AOR = 2.88, 95% CI: 1.85–4.48, p < 0.001) and kidney disease (AOR = 6.56, 95% CI: 2.39–18.02, p < 0.001) were significant predictors of mortality. Blood glucose (per 10 mg/dL increase; AOR = 1.03, 95% CI: 1.01–1.05, p < 0.001) and pulse rate (per bpm increase; AOR = 1.02, 95% CI: 1.01–1.03, p < 0.001) were also significantly associated with mortality. Multimorbidity was not independently associated with mortality in the main model (AOR = 1.63, 95% CI: 0.67–4.00, p = 0.278). In the interaction model, no statistically significant interaction between age and multimorbidity was observed. However, predicted probabilities suggested a higher mortality risk among older patients with multimorbidity compared to other groups.

Conclusion

Advanced age, dyspnea, kidney disease, elevated blood glucose, and pulse rate are significant predictors of COVID-19 mortality. While multimorbidity may contribute to mortality risk, no strong evidence of interaction between age and comorbidity burden was observed. These findings highlight the importance of comprehensive risk stratification using multiple clinical factors in hospitalized COVID-19 patients.

Clinical trial

Not applicable.