94 Percent of COVID Deaths Have Been Among Adults 50-Plus

It’s been five years since the start of the pandemic, and older adults continue to bear its burden

Rachel Nania,

AARP

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En español

Published March 14, 2025

Long COVID survivor, Cathy Lydon Mesa.

Frankie Alduino

Catherine Lydon Mesa remembers feeling like she had been hit by a train on a Saturday evening in September 2022.

“I was shaking so much from a fever that I had my hand under my chin to keep my teeth from clattering so loud,” recalls Mesa, now 61.

In the days that followed, she struggled to catch her breath, was tortured with headaches, and was so weak that she had to crawl from her bed to the bathroom.

“I couldn’t even stand up,” says Mesa, who lives in Queens, New York. Sitting in her bed to eat a bowl of soup would exhaust her.

The diagnosis: COVID-19, an illness that she had managed to avoid for more than two years since it first started spreading in the U.S. in early 2020. Given an underlying health condition — Mesa was diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS, in her 20s — she did what she could to lower her risks of getting infected with the coronavirus. She was vaccinated, boosted and wore a mask in public.

Still, the virus eventually found her, and it made her really sick — just like it’s done to millions of older adults.

It’s been five years since COVID-19 arrived in the U.S., and in that time, adults age 50 and older have accounted for roughly 94 percent of the 1.2-plus million American deaths. And while hospitalizations are fewer now than they were earlier in the pandemic, the illness is still sending thousands to inpatient wards and wings, and the vast majority are older individuals, data from the Centers for Disease Control and Prevention (CDC) shows.

Why COVID hits older adults so hard

Biological changes that develop with age are a big reason why older adults have borne — and continue to bear — the burden of this disease.

When you’re older, the immune system cannot fight off foreign invaders as well as it could in your younger years, explains Emily Landon, M.D., executive medical director for infection prevention and control and an associate professor of medicine at the University of Chicago Medicine. “And as we get older, your body isn’t as quick or as good at recognizing when something’s wrong.”

What’s more, older individuals are more likely to have underlying health conditions, like heart disease or lung disease. And when you pile on an infection, “those medical problems leave you at a disadvantage,” Landon says. An estimated 85 percent of Americans 65 and older have at least one chronic health condition, research suggests, and more than half have two.

A 2021 study led by federal researchers found that diabetes and obesity were among the leading risk factors for death from COVID-19. An estimated 1 in 3 U.S. adults 65 and older have diabetes, and more than 40 percent of adults 60 and older have obesity.

‘We had tons of patients’

Anthony W. Okolo, M.D., was a second-year medical resident practicing in the Bronx in early 2020. “I remember when we started hearing a lot about COVID, it came in waves of intensity — that’s the best way I would describe it,” says Okolo, now a hospitalist and geriatrician at Kings County Hospital in Brooklyn, New York.

At first, he recalls chatter about the outbreak abroad; then the virus was in the U.S. “And then the hospital became a full-blown COVID treatment hospital,” he says. Patients were filling the beds, and many of them were older individuals.

In Chicago, it was a similar scene. “We had tons of patients,” Landon says. “At one point, almost 50 percent of our hospital was just COVID patients. I mean, it was unbelievable.”

By mid-April 2020, about a month after lockdowns started, the hospitalization rate for adults 65 and older was 30.7 per 100,000 people, according to CDC data. For adults under the age of 50, the rate was much lower at 5.1 per 100,000.

“We didn’t have any native immunity whatsoever,” Landon says about the coronavirus in 2020. That has changed with the development of vaccines and with ongoing infections. Still, the virus continues to prey on older adults.

In early January 2025, the COVID-19 hospitalization rate for adults under 50 was 1.0 per 100,000 people; for individuals 65-plus, it was 18.3.

COVID’s lingering effects

It’s not just the initial infection that disproportionately impacts the older population. Some research suggests that COVID-19 is more likely to linger in older people, leaving them with new or persistent symptoms — a phenomenon known as long COVID.

A CDC study found that 1 in 4 adults age 65-plus have developed at least one long-term health issue as a result of COVID-19. Another large study published in the journal BMJ found almost 1 in 3 adults over the age of 65 sought medical care for new or ongoing COVID symptoms weeks after their initial illness.

Mesa, the Queens resident who caught COVID in 2022, is one of them. About a month after she first got sick with COVID-19, she went to see her physician for an unyielding cough and prolonged exhaustion. Her doctor suspected it was long COVID but wanted to give her a little more time to see if the symptoms cleared. Sometimes it takes longer for people with underlying health conditions to return to normal, Mesa was told.

Mesa gets a moment of respite in her bedroom.

Frankie Alduino

She hoped by the four-month mark, she would feel better. “That’s not what happened,” says Mesa, who was diagnosed with long COVID and is now a patient advocate for Solve M.E.'s Long COVID Patient Leadership Advancement Network.

More than two years after her run-in with COVID-19, she still struggles with its effects. Everyday tasks like showering and driving can be strenuous. Going out to dinner with friends will wipe her out for the following two days. A simple trip upstairs, “and the coughing fits come on again,” Mesa says.

She’s seen some improvement in her long COVID symptoms with medications, therapies and changes to her routine, but she’s still not back to her pre-pandemic self. Nonetheless, she says she feels “beyond fortunate” and tries to focus on what she can do rather than what she can’t.

“I also have a tremendous amount of gratitude because I was so sick, I feel that I was spared for a reason,” Mesa says.

The Next 5 Years of COVID

Living with long COVID

Millions of people suffer from long COVID, and many of them are older adults. Some of the most common symptoms older adults experience include:

Extreme tiredness or lack of energy (fatigue)
Trouble breathing or shortness of breath
Coughing
Joint pain and weakness
High blood pressure
Changes in smell or taste
Difficulty thinking, concentrating and remembering (brain fog)

Source: National Institute on Aging

These days, we’re better able to disrupt COVID’s destruction, in large part because of scientific advances made in the past five years. Vaccines developed at record speed help keep mild infections from turning severe. One report from the Commonwealth Fund found that the shots averted 18.5 million additional hospitalizations and 3.2 million additional deaths between December 2020 and November 2022 alone.

At-home tests that can alert you to an infection and prescription antiviral treatments to treat it have also helped turn the pandemic tides. “The medicines we have available for COVID right now are really good, but if you don’t know if you have COVID, then you can’t get the medicine,” Landon says, highlighting the importance of the nasal-swab test kits.

However, with COVID here to stay, there’s more work to do in our ongoing fight against the virus. Many doctors and researchers say vaccine acceptance is key to our continued success. Roughly 23 percent of the U.S. adult population received the 2024–2025 COVID-19 vaccine, according to CDC data. The share is higher among older adults, but not by much — an estimated 25 percent of Medicare beneficiaries had received the most recent COVID-19 vaccine as of November 2024, according to federal data.

“I think because we remember so acutely what the pandemic was like, and to not be in a state where we’re hearing sirens going off all hours of the day can have us lower our guard a little bit,” says Amanda K. Johnson, M.D., senior assistant vice president of care models in the Office of Ambulatory Care and Population Health for NYC Health + Hospitals. “But getting vaccinated is important for you, and it’s important for your loved ones.”

It’s possible we could see a combination flu-COVID vaccine in the next few years, which public health experts say could help boost vaccination rates. “For some folks, it is one or the other,” Johnson says.

Making headway with long COVID treatments is another goal for researchers in the forthcoming years. “There’s not the research base to tell us exactly how to treat and manage that condition just yet, and so I’m hoping that now that we’re out of the emergency response mode, we don’t lose sight of the millions of Americans who are still suffering and living with long COVID,” Johnson says.

An estimated 6 percent of U.S. adults have long COVID, according to a CDC study, and a significant share of them (about 20 percent) say the illness limits their ability to carry out daily activities.

“I just think that anything that anybody can do, no matter how big, how small, is a step in the right direction to helping the overall [long COVID] community,” Mesa says.

It may feel like the pandemic is behind us, but the public health community isn’t letting it fade too far in the rearview mirror. Now and in the years to come, they’re taking lessons from our experiences with COVID and preparing for future outbreaks — be it with the coronavirus or an entirely new pathogen.

“It’s so hard to imagine that we are five years out from the beginnings of the pandemic, but I’m hoping that people bear in mind that this is the kind of event that has happened before, and it’s possible that it could happen again in our lifetimes,” Johnson says.

Okolo adds, “We don’t know what’s coming next. We don’t know if we’ll ever have another pandemic to that scale, but I think what we can learn from COVID in real-time is the importance of having protocols and playbooks in place for if and when such an incident should happen again.”