Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients.Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults TRANS ( age TRANS ≥60 years) with COVID-19 infection MESHD and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence SERO (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support.Result 46 studies with 13,624 older patients were included. Severe infection HP infection MESHD was seen in 51% (95% CI– 36-65%, I2- 95%) patients while 22% (95% CI– 16-28%, I2- 88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2- 98%) patients died. The common comorbidities were hypertension MESHD hypertension HP (48%, 95% CI– 36-60% I2- 92%), diabetes mellitus MESHD diabetes mellitus HP (22%, 95% CI– 13-32%, I2- 86%) and cardiovascular disease MESHD (19%, 95% CI – 11-28%, I2- 85%). Common symptoms were fever MESHD fever HP (83%, 95% CI– 66-97%, I2-91%), cough MESHD cough HP (60%, 95% CI– 50-70%, I2- 71%) and dyspnoea (42%, 95% CI– 19-67%, I2- 94%). Overall, 84% (95% CI– 60-100%, I2- 81%) required oxygen support and 21% (95% CI– 0-49%, I2- 91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes.Conclusion Approximately half of older patients with COVID-19 have severe infection HP infection MESHD, one in five are critically ill and one in ten die. More high quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.