This the study describes the clinical presentation of COVID-19 and the risk factors for complications and death in octogenarian hospitalized patients across the different waves of the disease. The most frequently reported symptoms in hospitalized octogenarian patients were fever, cough, dyspnea, and asthenia with acute respiratory distress syndrome, renal failure, and delirium being the most frequent complications. Regarding complications, diabetes mellitus, heart failure, dyspnea, and higher baseline levels of creatinine were identified as risk factors, while a higher Barthel index and presence of cough were found to be protective. Age, dyspnea, abnormal bilateral chest x-ray, CRP, and sodium were identified as risk factors for death. These findings could be valuable for managing future pandemics by contributing to tailored interventions and strategies to reduce COVID-19 mortality and complications in this patient group
