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The COVID-19 pandemic causes severe morbidity and mortality. This multi-country study aimed to explore risk factors that drive mortality in COVID-19 patients who received neither dexamethasone nor remdesivir. We analyzed a cohort of 568 survivors and 507 non-survivors from China, European regions, and North America. Elderly males ≥70 years accounted for only 25% of survivors, but this rate was significantly higher in non-survivors from China (55%), European regions (63%), and North America (47%). Compared with survivors, non-survivors had more incidences of comorbidities such as cerebrovascular disease and chronic obstructive pulmonary disease (COPD, p-values<0.05). Survival analyses revealed age, male gender, shortness of breath, cerebrovascular disease, and COPD as mortality-associated factors. Survival time from symptom onset was significantly shorter in elderly versus young patients (median: 29 versus 62 days), males versus females (median: 46 versus 59 days), and patients with versus without comorbidities (mean: 41 versus 61 days). Mortality risk was higher in elderly males with comorbidities than in young females without comorbidities (p-value<0.01). Elderly male survivors with comorbidities also had longer hospital stays than other survivors (25 versus 18.5 days, p-value<0.01). Overall, the high mortality risk in elderly males with COVID-19-associated comorbidities supports early prevention and critical care for elderly populations.

Original publication




Journal article


Aging (Albany NY)

Publication Date





27 - 60


COVID-19, SARS-CoV-2, comorbidities, mortality, risk factors, Adolescent, Adult, Aged, Aging, COVID-19, Cardiovascular Diseases, Cerebrovascular Disorders, Child, Child, Preschool, Cohort Studies, Comorbidity, Female, Global Health, Humans, Infant, Liver Diseases, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive, Respiratory Tract Diseases, Risk Factors, SARS-CoV-2, Tuberculosis, Young Adult