• Valerie Danesh, Alaina Tellson, Leanne M Boehm, Alan B Stevens, Gerald O Ogola, Anisha Shrestha, Jinmyoung Cho, Edgar J Jimenez, and Alejandro C Arroliga.
• Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA. Valerie.Danesh@BSWHealth.org.
• J Gen Intern Med. 2024 Aug 1; 39 (10): 181118191811-1819.

BackgroundDespite the variability and complexity of geriatric conditions, few COVID-19 reports of clinical characteristic prognostication provide data specific to oldest-old adults (over age 85), and instead generally report broadly as 65 and older.ObjectiveTo examine metabolic syndrome criteria in adults across 25 hospitals with variation in chronological age.Design And ParticipantsThis cohort study examined 39,564 hospitalizations of patients aged 18 or older with COVID-19 who received inpatient care between March 13, 2020, and February 28, 2022.ExposureICU admission and/or in-hospital mortality.Main MeasuresMetabolic syndrome criteria and patient demographics were examined as risk factors. The main outcomes were admission to ICU and hospital mortality.Key ResultsOldest old patients (≥ 85 years) hospitalized with COVID-19 accounted for 7.0% (2758/39,564) of all adult hospitalizations. They had shorter ICU length of stay, similar overall hospitalization duration, and higher rates of discharge destinations providing healthcare services (i.e., home health, skilled nursing facility) compared to independent care. Chronic conditions varied by age group, with lower proportions of diabetes and uncontrolled diabetes in the oldest-old cohort compared with young-old (65-74 years) and middle-old (75-84 years) groups. Evaluations of the effect of metabolic syndrome and patient demographics (i.e., age, sex, race) on ICU admission demonstrate minimal change in the magnitude of effect for metabolic syndrome on ICU admission across the different models.ConclusionsMetabolic syndrome measures are important individual predictors of COVID-19 outcomes. Building on prior examinations that metabolic syndrome is associated with death and ARDS across all ages, this analysis supports that metabolic syndrome criteria may be more relevant than chronological age as risk factors for poor outcomes attributed to COVID-19.© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.

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