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Our objective was to compare rates of secondary infections and long-term outcomes of elderly and non-elderly patients who received baricitinib for COVID-19. We conducted a single-centre observational study between November 2020 and September 2023, focusing on hospitalized adult SARS-CoV-2 patients with CSS, categorized as elderly (\u2265\u200965\u00a0years) and non-elderly (&lt;\u200965\u00a0years). Enrolment, severity stratification, and diagnosis of infectious complications followed predefined criteria. Outcomes of all-cause mortality and rates of non-severe and severe secondary infections were assessed at 1-year post-treatment initiation. Kaplan\u2013Meier analysis was performed for survival analysis. In total, 490 patients were enrolled (median age 65\u2009\u00b1\u200923 (21\u2013100) years (years, median\u2009\u00b1\u2009IQR, min\u2013max); 49.18% elderly; 59.59% male). Elderly patients were admitted to the hospital significantly earlier (7\u2009\u00b1\u20095\u00a0days vs. 8\u2009\u00b1\u20094\u00a0days; <jats:italic>p<\/jats:italic>\u2009=\u20090.02), experienced a higher occurrence of severe COVID-19 (121\/241, 50.21% vs. 98\/249, 39.36%; <jats:italic>p<\/jats:italic>\u2009=\u20090.02), and required the use of non-invasive ventilation at baseline (167\/225, 74.22% vs. 153\/236, 64.83%; <jats:italic>p<\/jats:italic>\u2009=\u20090.03). At 1\u00a0year, all-cause mortality was significantly higher in the elderly subgroup (111\/241, 46.06% vs. 29\/249, 11.65%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). At 90\u00a0days and 1\u00a0year, rates of any severe secondary infection were also more prevalent among the elderly (56\/241, 23.24% vs. 37\/249 14.86%; <jats:italic>p<\/jats:italic>\u2009=\u20090.02 and 58\/241, 24.07% vs. 39\/249, 15.66%; <jats:italic>p<\/jats:italic>\u2009=\u20090.02). In conclusion, elderly SARS-CoV-2-infected patients experience a more severe clinical course, higher secondary infection rates, and increased risk for long-term mortality, regardless of immunomodulatory therapy.<\/jats:p>","DOI":"10.1007\/s11357-024-01099-y","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T06:02:04Z","timestamp":1708149724000},"page":"2863-2877","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Secondary infections and long-term outcomes among hospitalized elderly and non-elderly patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and treated with baricitinib: a comparative study from the national centre of Hungary"],"prefix":"10.1007","volume":"46","author":[{"given":"Zs\u00f3fia","family":"G\u00e1sp\u00e1r","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-1356","authenticated-orcid":false,"given":"B\u00e1lint Gergely","family":"Szab\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajnalka","family":"Andrikovics","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Cegl\u00e9di","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"RAJMON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"\u00c1brah\u00e1m","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsuzsanna","family":"V\u00e1rnai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"No\u00e9mi","family":"Kiss-Dala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"Szl\u00e1vik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"Sink\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Istv\u00e1n","family":"V\u00e1lyi-Nagy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Botond","family":"Lakatos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"1099_CR1","unstructured":"Infectious Diseases Society of America. 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The institutional review board of South Pest Central Hospital, National Institute of Haematology and Infectious Diseases approved the study protocol. Written informed consent was obtained from each patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article. The \u201cCopyright Transfer Statement\u201d was completed by the corresponding author on behalf of all co-authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the data in Table , ,  and .","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}