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Background: Secondary infection with other pathogens is associated with poor prognosis in patients with viral infections. However, the characteristics of elderly patients and secondary infections are not well known; therefore, we conducted this study.

Methods: We retrospectively reviewed confirmed cases of COVID-19 admitted between February 1 and December 31, 2020. Univariate and multivariate logistic regression analyseswere performed to identify the predictors of in-hospital mortality.

Results: A total of 298 patients with confirmed COVID-19were identified during the study period. Among these, 171 patients (57.4%)were non-elderly (50–64 years) and 127 patients (42.6%)were elderly (over 65 years of age). Patients in the elderly group had a higher frailty scale, and the most common underlying diseases were hypertension, diabetes, heart failure, chronic kidney disease and cerebral vascular accident. The mortality rate was also higher in the elderly group (12.6% vs. 1.2%, p < 0.001). Secondary infectionwas confirmed in 12.8% of patients (38/298). Streptococcus pneumonia (22/38, 57.9%) as the most common pathogen in the COVID-19 patients. Secondary infection and elderly were associated with in-hospital mortality.

Conclusions: In this study, 42.6% of patients were elderly COVID-19 patients and 12.8% of patients had secondary infections. Elderly patients and secondary infections were associated with in-hospital mortality.