Publication date: Sep 05, 2025

As the global battle against COVID-19 continues, understanding the factors contributing to severe outcomes remains critical for public health strategies. We aim to identify the determinants significantly influencing severe COVID-19 infection and mortality among the general population in Taiwan. We conducted a retrospective cohort study using data extracted from the Taipei Medical University Clinical Research Database from 1 January 2022 to 31 December 2022. We defined the primary outcomes as severe COVID-19 infection, including hospitalisation, ventilator use, intubation, and mortality. We performed logistic regression analyses to explore the association of various factors, including demographic characteristics, body mass index (BMI), Charlson Comorbidity Index score, and multiple comorbidities. Among 96 489 confirmed COVID-19 cases, 44 996 (46. 6%) were classified as high-risk patients. Compared to females, male patients had significantly higher risks of ventilator use (odds ratio (OR) = 1. 245; 95% confidence interval (CI) = 1. 147-1. 352, P 

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