Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis
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Open Access
- 26 March 2020
- journal article
- research article
- Published by European Respiratory Society (ERS) in European Respiratory Journal
- Vol. 55 (5), 2000547
- https://doi.org/10.1183/13993003.00547-2020
Abstract
Background The coronavirus disease 2019 (Covid-19) outbreak is evolving rapidly worldwide. Objective To evaluate the risk of serious adverse outcomes in patients with coronavirus disease 2019 (Covid-19) by stratifying the comorbidity status. Methods We analysed the data from 1590 laboratory-confirmed hospitalised patients 575 hospitals in 31 province/autonomous regions/provincial municipalities across mainland China between December 11th, 2019 and January 31st, 2020. We analyse the composite endpoints, which consisted of admission to intensive care unit, or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared according to the presence and number of comorbidities. Results The mean age was 48.9 years. 686 patients (42.7%) were females. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 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 [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424–5.048], diabetes (HR 1.59, 95%CI 1.03–2.45), hypertension (HR 1.58, 95%CI 1.07–2.32) and malignancy (HR 3.50, 95%CI 1.60–7.64) were risk factors of reaching to the composite endpoints. The HR was 1.79 (95%CI 1.16–2.77) among patients with at least one comorbidity and 2.59 (95%CI 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.Funding Information
- National Health Commission (NA)
- Guangdong Science and Technology Department (NA)
This publication has 35 references indexed in Scilit:
- A Comparative Study of Clinical Presentation and Risk Factors for Adverse Outcome in Patients Hospitalised with Acute Respiratory Disease Due to MERS Coronavirus or Other CausesPLOS ONE, 2016
- Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysisInternational Journal of Infectious Diseases, 2016
- Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteriaInternational Journal of Infectious Diseases, 2015
- Association of Age and Comorbidity on 2009 Influenza A Pandemic H1N1-Related Intensive Care Unit Stay in MassachusettsAmerican Journal of Public Health, 2014
- Network-based analysis of comorbidities risk during an infection: SARS and HIV case studiesBMC Bioinformatics, 2014
- Effect of Race/Ethnicity and Socioeconomic Status on Pandemic H1N1-Related Outcomes in MassachusettsAmerican Journal of Public Health, 2014
- Clinical Findings in 111 Cases of Influenza A (H7N9) Virus InfectionThe New England Journal of Medicine, 2013
- The burden of influenza complications in different high-risk groups: a targeted literature reviewJournal of Medical Economics, 2012
- Differences in the Epidemiological Characteristics and Clinical Outcomes of Pandemic (H1N1) 2009 Influenza, Compared with Seasonal InfluenzaInfection Control & Hospital Epidemiology, 2010
- Clinical Features and Short-term Outcomes of 144 Patients With SARS in the Greater Toronto AreaJAMA, 2003