To estimate the biological age of elderly people hospitalized with a confirmed diagnosis of COVID-19, and its relationship with mortality. A retrospective and quantitative cohort study, carried out in a public hospital in the city of Recife-PE, from April 2020 to April 2021, with 115 elderly people of both sexes. The biological age of the participants was estimated by a calculator that uses nine laboratory blood tests and mortality was analyzed. Of the 115 elderly people hospitalized in a public referral hospital for COVID-19, the predominant gender was male, age ≥ 70 years, black/brown skin color, illiterate/low education, with a partner. Arterial hypertension and diabetes were the most common comorbidities in the study population. Regarding ICU admission, use of mechanical ventilation, length of ICU stays and mortality, there was a significant association with premature aging (p-value = 0.009, 0.009, 0.042 and 0.009 respectively). The biological Age was able to predict clinical outcomes, proving to be superior to Chronological Age.