【Abstract】Objective This study was to clarify the hematological characteristics of elderly patients aged 75 with COVID19 to guide rational treatment. Methods A retrospective analysis of novel coronavirus pneumonia (aged over 75 years) was conducted in Wuhan Huoshen Mountain Hospital from February 3, 2020 to March 30th. According to the clinical classification, they were divided into the common type group and the severe type group. The severe group was divided into severe cure group and severe death group according to the prognosis. Results A total of 326 elderly patients were included in this study, including 160 cases in the common type group and 166 cases in the severe type group. Among them, 143 cases in the severe type group were cured and 23 cases died. 166 cases were male and 160 cases were female, among which the probability of male suffering from severe type was higher than that of female. 475% of the elderly patients had two or more kinds of underlying diseases. They had a higher risk of developing severe pneumonia, but had no significant effect on the prognosis. Compared with the normal type group, the ratio of leukocytosis and lymphocytopenia, the median and abnormal increase of CRP and IL 6, and the abnormal rate of LDH in the severe type group were significantly higher (P＜005). In the severe group, compared with the cured group, patients in the death group usually had higher white blood cell count and granulocyte to lymphocyte ratio, lower lymphocyte count and platelet count, 95% of patients had increased CRP, D dimer, IL 6 and PCT, 87% of patients had increased lactate dehydrogenase and 87% of patients had increased creatine kinase. Conclusion The elderly patients with COVID19, combined with more than two kinds of chronic diseases, were higher incidence of severe pneumonia and poorer treatment efficacy. We should pay more attention to the levels of lymphocyte, NLR, platelet, infected markers and cardiomyocyte injury markers for early diagnosis and treatment, so as to improve the prognosis and reduce the mortality.