Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis

By W. Guan, W. Liang, Yi Zhao, Hengrui Liang, Zisheng Chen, Yi-min Li, Xiao-qing Liu, Ru-chong Chen, Chun-li Tang, Taojiao Wang and 37 more. European Respiratory Journal, 2020

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Background The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. Objective To evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status. Methods We analysed data from 1590 laboratory confirmed hospitalised patients from 575 hospitals in 31 provinces/autonomous regions/provincial municipalities across mainland China between 11 December 2019 and 31 January 2020. We analysed the composite end-points, which consisted of admission to an intensive care unit, invasive ventilation or death. The risk of reaching the composite end-points was compared according to the presence and number of comorbidities. Results The mean age was 48.9 years and 686 (42.7%) patients were female. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached the composite end-points. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD (HR (95% CI) 2.681 (1.424–5.048)), diabetes (1.59 (1.03–2.45)), hypertension (1.58 (1.07–2.32)) and malignancy (3.50 (1.60–7.64)) were risk factors of reaching the composite end-points. The hazard ratio (95% CI) was 1.79 (1.16–2.77) among patients with at least one comorbidity and 2.59 (1.61–4.17) among patients with two or more comorbidities. Conclusion Among laboratory confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes. The presence and number of comorbidities predict clinical outcomes of COVID-19 http://bit.ly/3b9ibw5

Subfields: Epidemiology, Infectious Diseases, Oncology

View Paper: https://www.semanticscholar.org/paper/c7e13016bef221a52147b72e7a16e497c850240d

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Citations in the corpus

Kidney disease is associated with in-hospital death of patients with COVID-19 (2020, background): “Based on review of the literature, 14, 27, 28 several covariates were selected for analysis as potential confounding variables in our regression analyses.”
Diabetes is a risk factor for the progression and prognosis of COVID‐19 (2020, neutral): “5-81] vs 23 [10-49]), as well as D-dimer (1.”
Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis (2020, positive): “Our results on prevalence are similar to a large Chinese nationwide study of 1590 patients which had shown the prevalence of diabetes in COVID-19 patients to be 8.2% [23] .”