Objectives To determine the age TRANS-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and setting This is a retrospective, multi-center cohort study performed at twenty-four hospitals in Jiangsu, China. Participants From January 10 to March 15, 2020, 625 patients with COVID-19 were involved. Results Of the 625 patients (median age TRANS, 46 years; 329 [52.6%] males TRANS), 37 (5.9%) were children TRANS (18 years or less), 261 (40%) young adults TRANS (19-44 years), 248 (39.7%) middle- aged TRANS adults TRANS (45-64 years), and 79 (12.6%) elderly TRANS (65 years or more). The incidence of hypertension MESHD hypertension HP, coronary heart disease MESHD disease, chronic obstructive pulmonary HP chronic obstructive pulmonary disease MESHD, and diabetes comorbidities increased with age TRANS (trend test, P < .0001, P = 0.0003, P < .0001, and P < .0001 respectively). Fever MESHD Fever HP, cough MESHD cough HP, and shortness of breath occurred more commonly among older patients, especially the elderly TRANS, compared to children TRANS (Chi-square test, P = 0.0008, 0.0146, and 0.0282, respectively). The quadrant score and pulmonary opacity HP score increased with age TRANS (trend test, both P < .0001). Older patients had significantly more abnormal values in many laboratory parameters than younger patients. Elderly TRANS patients contributed the highest proportion of severe or critically-ill cases (33.0%, Chi-square test P < 0.001), intensive care unit (ICU) (35.4%, Chi-square test P < 0.001), and respiratory failure HP (31.6%, Chi-square test P = 0.0266), and longest hospital stay (21 days, ANOVA-test P < 0.001). Conclusions Elderly TRANS ([≥]65) patients with COVID-19 had the highest risk of severe or critical illness MESHD, intensive care use, respiratory failure HP, and the longest hospital stay, which may be due partly to that they had higher incidence of comorbidities and poor immune responses to COVID-19.