Clinical and Multiorgan Proteomics Characteristics of the Diverse Fatal Phase in Super Elderly Patients With SARS‐CoV‐2 Infection: A Descriptive Study

ABSTRACT This study aims to identify the risk factors associated with clinical outcomes and the proteomic changes in organs related to fatal SARS‐CoV‐2 infection within the super‐elderly population. This retrospective analysis included all elderly individuals with COVID‐19 admitted to the Second Medical Center of PLA General Hospital from December 2022 to January 2023. The follow‐up period ended on March 30, 2023. During this time, epidemiological, demographic, laboratory, and outcome data were analyzed descriptively. Proteomic sequencing was performed on super‐elderly patients who died from COVID‐19 at different stages of the disease. A total of 352 elderly COVID‐19 patients, with a mean age of 89.84 ± 8.54 years, were included in this study. During a median follow‐up period of 98 days, 79 patients died. Deceased patients were older and more likely to have cardiovascular and cerebrovascular diseases, with a lower prevalence of lipid‐lowering therapy. The number of deaths in the acute and post‐acute phases were 34 and 45, respectively. Proteomics data suggest that the immune systems of patients who died in the acute phase underwent a more rapid and severe onslaught. Patients in the post‐acute phase showed higher levels of viral genome replication and a more robust immune response. However, the over‐activation of the immune system led to systemic organ dysfunction. Effective management of comorbidities may improve the prognosis of COVID‐19 in super‐elderly patients. The continuous replication of the SARS‐CoV‐2 virus and its subsequent impact on the immune system are critical determinants of survival time in this demographic.