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A total of 281 older patients with severe COVID-19 were categorized into two age groups (60\u201379\u00a0years and\u2009\u2265\u200980\u00a0years). Epidemiological, clinical, and laboratory data, and outcome were obtained. Patients aged\u2009\u2265\u200980\u00a0years had higher mortality (63.6%) than those aged 60\u201379\u00a0years (33.5%). Anorexia and comorbidities including hypertension, diabetes and COPD, higher levels of lactate dehydrogenase (LDH), osmotic pressure, C-reactive protein, D-dimer, high-sensitivity troponin I and procalcitonin, and higher SOFA scores were more common in patients aged\u2009&gt;\u200980\u00a0years than those aged 60\u201379\u00a0years and also more common and higher in non-survivors than survivors. LDH, osmotic pressure, C-reactive protein, D-dimer, high-sensitivity troponin I, and procalcitonin were positively correlated with age and sequential organ failure assessment (SOFA), whereas CD8+\u2009and lymphocyte counts were negatively correlated with age and SOFA. Anorexia, comorbidities including hypertension, diabetes, and chronic obstructive pulmonary disease (COPD), LDH, osmotic pressure, and SOFA were significantly associated with 28-day all-cause mortality. LDH, osmotic pressure and SOFA were valuable for predicting 28-day all-cause mortality, whereas the area under the receiver operating characteristic curve of LDH was the largest, with sensitivity of 86.0% and specificity of 80.8%. Therefore, patients with severe COVID-19 aged\u2009\u2265\u200980\u00a0years had worse condition and higher mortality than did those aged 60\u201379\u00a0years, and anorexia and comorbidities including hypertension, diabetes, COPD, elevated plasma osmotic pressure, LDH, and high SOFA were independent risk factors associated with 28-day all-cause mortality in older patients with severe COVID-19. LDH may have the highest predictive value for 28-day all-cause mortality in all examined factors.<\/jats:p>","DOI":"10.1038\/s41598-020-79508-3","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T11:03:02Z","timestamp":1608634982000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Risk factors associated with 28-day all-cause mortality in older severe COVID-19 patients in Wuhan, China: a retrospective observational study"],"prefix":"10.1038","volume":"10","author":[{"given":"Yi","family":"Jiang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subi","family":"Abudurexiti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng-Meng","family":"An","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"79508_CR1","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1007\/s10096-020-03874-z","volume":"39","author":"H Ge","year":"2020","unstructured":"Ge, H. et al. 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