The effect of age on mortality in patients with Covid-19: a metanalysis with 611,583 subjects

Bonanad, Clara; García-Blas, Sergio; Tarazona-Santabalbina, Francisco; Sanchis, Juan; Bertomeu-González, Vicente; Fácila, Lorenzo; Ariza, Albert; Núñez, Julio; Cordero, Alberto

ABSTRACT Objectives Initial data on Covid-19 infection has pointed out a special vulnerability of elderly people. Design we performed a meta-analysis with available national reports at May 7th 2020 from China, Italy, Spain, United Kingdom and New York State. Analyses were performed by a random effects model and sensitivity analyses were performed for the identification of potential sources of heterogeneity. Setting and Participants: covid-19 positive patients reported in literature and national reports. Measures all-cause mortality by age. Results A total of 611,1583 subjects were analyzed and 141,745 (23.2%) had age ≥80. The percentage of octogenarians was different in the 5 registries being the lowest in China (3.2%) and the highest and the highest in UK and New York State. The overall mortality rate was 12.10% and it varied widely between countries being the lowest in China (3.1%) and the highest in UK (20.8%) and New York State (20.99%). Mortality was <1.1% in patients with age <50 and it increased exponentially after that age in the 5 national registries. As expected, the highest mortality rate was observed in patients ≥80 years old. All age groups had significantly higher mortality compared to the inmediatelly younger age group. The largest increase in mortality risk was observed in patients with age 60-69 compared to 50-59 (OR: 3.13 95% CI 2.61-3.76). Conclusions and implications this metanalysis with more than half-million of Covid-19 patients from different countries highlights the determinant effect of age on mortality with the relevant thresholds on age >50 and, especially, >60. Elderly patients should be priorized in the implementation of preventive measures.