Objective To explore the risk factors affecting the prognosis of elderly severe or critically ill patients infected with 2019 novel coronavirus. Methods A total of 61 old patients (over 60 years old) infected with 2019 novel coronavirus who were admitted to a ward of a designated hospital in Wuhan from January to March 2020 were selected as the research subjects, and their clinical data were collected and retrospectively analyzed. SPSS statistics 22.0 was used for data analysis. According to data types, student′s t test, rank sum test or Chi-square test was used for intergroup comparison. Cox regression model was used to analyze the survival of patients. Results The elderly patients with severe and critical illness had a mortality rate of 55.7% (34/61). The death group showed the following features:very old, female, longer time of onset, high proportion of dyspnea, higher levels of aspartate transaminase, alkaline phosphatase, lactate dehydrogenase, urea nitrogen, creatinine, creatine kinase isoenzyme, C-reactive protein and neutrophilic granulocyte count, and low levels of albumin, calcium and lymphocyte count. The independent risk factors influencing the prognosis of elderly patients with severe and critical diseases were creatine kinase isoenzyme (P=0.000, HR=1.065,95%CI 1.034-1.096), albumin (P=0.001, HR=0.867,95%CI 0.797-0.943), calcium (P=0.000, HR=0.089,95%CI 0.028-0.279), and dyspnea (P=0.004, HR=6.538,95%CI 1.840-23.237). Conclusion High creatine kinase isoenzyme, low albumin, low blood calcium, and dyspnea are independent risk factors for elderly severe and critically ill patients infected with 2019 novel coronavirus.