Age, Multiple Chronic Conditions, and COVID-19: A Literature Review

Background Various patient demographic and clinical characteristics have been associated with poor outcomes for individuals with coronavirus disease 2019 (COVID-19). To describe the importance of age and chronic conditions in predicting COVID-19-related outcomes. Methods Search strategies were conducted in PubMed/MEDLINE. Daily alerts were created. Results A total of 28 studies met our inclusion criteria. Studies varied broadly in sample size (n = 21 to more than 17,000,000). Participants' mean age ranged from 48 years to 80 years, and the proportion of male participants ranged from 44% to 82%. The most prevalent underlying conditions in patients with COVID-19 were hypertension (range: 15%-69%), diabetes (8%-40%), cardiovascular disease (CVD) (4%-61%), chronic pulmonary disease (1%-33%), and chronic kidney disease (range 1%-48%). These conditions were each associated with an increased in-hospital case fatality rate (CFR) ranging from 1% to 56%. Overall, older adults have a substantially higher case fatality rate (CFR) as compared to younger individuals affected by COVID-19 (42% for those 65 years). Only one study examined the association of chronic conditions and the risk of dying across different age groups; their findings suggested similar trends of increased risk in those < 65 years and those > 65 years as compared to those without these conditions. Conclusions There has been a traditional, single-condition approach to consideration of how chronic conditions and advancing age relate to COVID-19 outcomes. A more complete picture of the impact of burden of multimorbidity and advancing patient age is needed.

Automated summary

Various patient demographic and clinical characteristics have been associated with poor outcomes for individuals with COVID-19. Older adults and patients with chronic conditions have a higher case fatality rate. Additionally, individuals with chronic conditions have an increased risk of dying across different age groups.