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Objective: Coronavirus disease 2019 (COVID-19) has raised concern around the world as an epidemic or pandemic.As data on COVID-19 has grown,it has become clear that older adults have a disproportionately high rate of death from COVID-19.This study describes the early clinical characteristics of COVID-19 in patients with more than 80 years of age.Methods: Epidemiological,clinical,laboratory,radiological,and treatment data from 17 patients diagnosed with COVID-19 between January 20 and February 20,2020 were collected and analyzed retrospectively.Treatment outcomes among subgroups of patients with non-severe and severe symptoms of COVID-19 were compared.Results: Of the 17 hospitalized patients with COVID-19,the median age was 88.0 years (interquartile range,86.6-90.0 years;range,80.0-100.0 years) and 12 (70.6%) were men.The age distribution of patients was not significantly different between non-severe group and severe group.All patients had chronic pre-existing conditions.Hypertension and cardiovascular diseases were the most common chronic conditions in both subgroups.The most common symptoms at the onset of COVID-19 were fever (n =13;76.5%),fatigue (n =11;64.7%),and cough (n =5;29.4%).Lymphopenia was observed in all patients,and lymphopenia was significantly more severe in the severe group than that in non-severe group (0.4 × 109/L vs 1.2 × 109/L,P =0.014).The level of serum creatinine was higher in the severe group than in the non-severe group (99.0 μmol/L vs 62.5 μmol/L,P =0.038).The most common features of chest computed tomography images were nodular foci in 10 (58.8%) patients and pleural thickening in 7 (41.2%) patients.All patients received antiviral therapy,while some patients also received intravenous antibiotics therapy (76.5%),Chinese medicinal preparation therapy (Lianhuaqingwen capsule,64.7%),corticosteroids (35.3%) or immunoglobin (29.4%).Eight patients (47.1%) were transferred to the intensive care unit because of complications.Ten patients (58.8%) received intranasal oxygen,while 3 (17.6%) received non-invasive mechanical ventilation,and 4 (23.5%) received high-flow oxygen.As of June 20,7 (41.2%) patients had been discharged and 10 (58.8% of this cohort,77.8% of severe patients) had died.Conclusion: The mortality of patients aged 80 years and older with severe COVID-19 symptoms was high.Lymphopenia was a characteristic laboratory result in these patients,and the severity of lymphopenia was indicative of the severity of COVID-19.However,the majority of patients with COVID-19 in this age cohort had atypical symptoms,and early diagnosis depends on prompt use of a viral nucleic acid test.