Background: Elderly patients with COVID-19 often exhibit a complex interplay between hypercoagulability and coagulopathy, key factors in determining the risk of severe complications and mortality. This study aimed to analyze coagulation and inflammatory markers to identify critical predictors of adverse outcomes in this vulnerable population. Material and Methods: The retrospective study was conducted on a sample of 1429 elderly patients (≥60 years) diagnosed with COVID-19, hospitalized in “Sf. Ap. Andrei” St. Apostle Andrew’s County Emergency Hospital in various wards between March 2020 and August 2022. Data were collected from medical records and included inflammatory markers (C-reactive protein, procalcitonin, ESR) and coagulation markers (prothrombin time, INR, fibrinogen, D-dimer). The SPSS 2.0 statistical software was used to conduct the study. Results:Coagulation markers: Prothrombin activity averaged 74.22%, below normal levels, indicating a heightened bleeding risk, while fibrinogen levels were significantly elevated (mean: 531.69 mg/dL), reflecting hypercoagulability. Prolonged prothrombin time (mean: 17.28 s) and elevated INR (International normalized ratio) (mean: 1.51) were associated with increased mortality, emphasizing their role in risk stratification. Elevated D-dimer levels (mean: 2.75 mg/L) further highlighted thromboembolic risks. Inflammatory markers: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) showed marked elevations (mean CRP: 92.09 mg/L, mean ESR: 58.47 mm/h), correlating with heightened systemic inflammation and poor outcomes. Bacterial infections: Elevated procalcitonin (mean: 1.98 ng/mL) suggested secondary bacterial infections, particularly in mechanically ventilated patients, significantly worsening prognosis. Conclusions: The duality of hypercoagulability and coagulopathy in elderly COVID-19 patients underscores the importance of consistently monitoring coagulation markers such as prothrombin time, INR, D-dimer, and fibrinogen. Simultaneously, elevated inflammatory markers and secondary bacterial infections require prompt therapeutic interventions. This study highlights the critical need for personalized management strategies to mitigate complications and reduce mortality in this high-risk population.

Background: The COVID-19 pandemic has disproportionately affected the elderly population, with inflammation and impaired immune response being key drivers of disease progression. Clinicians require predictive models integrating immunological and inflammatory biomarkers to optimize risk stratification in this vulnerable group. Methods: We retrospectively analyzed 1429 elderly patients (aged >60 years) admitted with COVID-19 between March 2020 and August 2022. Demographic, clinical, and laboratory data were collected at admission. Correlation and regression analyses were performed to assess the prognostic significance of hematological and inflammatory markers. Results: Lymphopenia and neutrophilia were predominant findings, frequently associated with elevated C-reactive protein levels. Correlation analyses revealed significant associations between inflammatory markers and discharge status or death, while lymphocytes exerted a protective effect, reducing mortality risk by 14.4%. Notably, a higher platelet-large cell ratio (PLCR) was linked to increased mortality, suggesting an important contribution of thrombosis to severe COVID-19. Conclusions: Our findings indicate that immunological and inflammatory markers may serve as significant predictors of outcomes in elderly COVID-19 patients. While the predictive power of the model remains limited, these biomarkers can contribute to a better understanding of patient trajectories and may inform therapeutic strategies.