UMass Chan Medical School Faculty Publications

UMMS Affiliation

Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine; Department of Population and Quantitative Health Sciences; Lamar Soutter Library

Publication Date


Document Type

Article Postprint


Clinical Epidemiology | Epidemiology | Geriatrics | Gerontology | Infectious Disease | Virus Diseases


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%-82%. The most prevalent underlying conditions in patients with COVID-19 were hypertension (range: 15% - 69%), diabetes (8% - 40%), cardiovascular disease (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 ranging from 1% to 56%. Overall, older adults have a substantially higher case fatality rate (CFR) as compared with younger individuals affected by COVID-19 (42% for those < 65 vs 65% > 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 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.


COVID-19, epidemiology, multimorbidity

Rights and Permissions

© The Author(s) 2020. Accepted Manuscript posted with 12-month embargo as allowed by publisher's self archiving policy at This is a pre-copyedited, author-produced version of an article accepted for publication in J Gerontol A Biol Sci Med Sci. following peer review. The version of record will be available online at

DOI of Published Version



Tisminetzky M, Delude C, Hebert T, Carr C, Goldberg RJ, Gurwitz JH. Age, Multiple Chronic Conditions, and COVID-19: A literature review. J Gerontol A Biol Sci Med Sci. 2020 Dec 24:glaa320. doi: 10.1093/gerona/glaa320. Epub ahead of print. PMID: 33367606. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

The journals of gerontology. Series A, Biological sciences and medical sciences

PubMed ID


glaa320_suppl_supplementary_material.pdf (283 kB)
Supplementary data