Publication date: Jan 02, 2025

Elderly patients with multiple concomitant chronic diseases are the particularly vulnerable during the Coronavirus disease 2019 (COVID-19) epidemic, which accounts for a large number of COVID-19-related deaths. The purpose of the study was to investigate the impact of polypharmacy and potentially inappropriate medications (PIMs) on in-hospital mortality in a secondary hospital in China. A cross-sectional, retrospective study was conducted using electronic medical data collected from Shanghai Gonghui Hospital from April 2022 to June 2022. Two types of PIMs were adopted, involving the evaluation of the PIM status of older patients with COVID-19 (age ≥ 60 years) identified by AGS/Beers Criteria (PIM-Beers) and the PIM related to Covid-19 antiviral NMV/r (Nirmatrelvir/ritonavir) (PIM-NMV/r). Multivariate logistic regression was used to identify the risk factors associated with PIM use and in-hospital mortality. A total of 617 older COVID-19 inpatients were included in the study. The prevalence of polypharmacy and excessive polypharmacy were 24. 6% and 19. 1%, respectively. The prevalence of PIMs, PIM-Beers, and PIM-NMV/r were 25. 8%, 22. 5%, and 60. 8%, respectively. Multivariate regression demonstrated that male (OR: 0. 57 [95% CI: 0. 33-0. 98], p = 0. 044), diabetes (OR: 2. 05 [95% CI: 1. 11-3. 80], p = 0. 023), the more number of medications (OR: 1. 44 [95% CI: 1. 20-1. 72], p 

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