Objective To explore the efficacy of low-dose and short-course glucocorticoid treatment on moderate coronavirus disease 2019 (COVID-19) in elderly patients. Methods Clinical data of patients aged ≥80 years, diagnosed with COVID-19, and admitted to a hospital from December 9, 2022, to February 9, 2023 were investigated retrospectively. According to whether low-dose glucocorticoids was administered intravenously after admission, patients were divided into non-hormone usage group and hormone usage group. General information and laboratory test results of two groups of patients were described, changes of patients' conditions within 30 days were observed, and difference in efficacy between the two groups was compared. Results A total of 62 patients were recruited, including 21 in the non-hormone usage group and 41 in the hormone usage group. The general information and laboratory test indicators before treatment between two groups of patients showed no statistically significant differences (both P>0.05). Except hormone usage, there was no statistically significant difference in other treatment methods (all P>0.05). After treatment with glucocorticoids for 10 days, the clinical manifestations of cough (34.1% vs 66.7%), expectoration (19.5% vs 61.9%), palpitation (4.9% vs 23.8%) and shortness of breath (7.3% vs 28.6%) in the hormone usage group decreased compared with those in the non-hormone usage group, differences were statistically significant (all P < 0.05). After 10 days of treatment, compared with patients in the non-hormone usage group, the oxygenation indicator and lymphocyte count of patients in the hormone usage group increased, while the values of C-reactive protein and D-dimer decreased, with statistically significant differences (all P < 0.05). The incidence of disease exacerbation in the hormone usage group was lower than that in the non-hormone usage group (14.6% vs 47.6%), difference was statistically significant(χ² =7.895, P=0.005). Conclusion Low-dose and short-course systemic glucocorticoid usage in elderly patients with moderate COVID-19 can effectively control the progress of the disease and improve prognosis.