Background and Objective:
The severe course of COVID-19 in older adults—especially those with underlying conditions—and their higher mortality rates prompted physicians to use various drug regimens for treatment. This study aimed to compare the outcomes of dexamethasone-containing regimens versus those without dexamethasone in elderly patients with COVID-19.

Methods:
In this retrospective cohort study, medical records of elderly COVID-19 patients hospitalized in educational hospitals in Khorramabad from the start of the pandemic to January 2021 were reviewed via census sampling. Data were collected using a researcher-made checklist covering demographic data, symptoms, and treatment outcomes. SPSS21 was used for data analysis through ANOVA, Chi-square, Mann–Whitney, and Kruskal–Wallis tests.

Results:
Among the 900 reviewed cases, 49.1% were male. The five treatment regimens were homogeneous regarding age, gender, smoking, BMI, comorbidities, PCR results, recurrence, and rehospitalization (p>0.05). Regimens with dexamethasone significantly reduced ICU admission and hospital stay (p<0.001), but no significant difference was found in mortality (p=0.072). Dexamethasone regimens were associated with lower disease severity compared to those without it (p<0.001).

Conclusion:
Dexamethasone-containing regimens may reduce disease severity, ICU transfer, and hospitalization duration in elderly COVID-19 patients. Further studies are recommended