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

Author:

Guan Wei-jie,Liang Wen-hua,Zhao Yi,Liang Heng-rui,Chen Zi-sheng,Li Yi-min,Liu Xiao-qing,Chen Ru-chong,Tang Chun-li,Wang Tao,Ou Chun-quan,Li Li,Chen Ping-yan,Sang Ling,Wang Wei,Li Jian-fu,Li Cai-chen,Ou Li-min,Cheng Bo,Xiong Shan,Ni Zheng-yi,Xiang Jie,Hu Yu,Liu Lei,Shan Hong,Lei Chun-liang,Peng Yi-xiang,Wei Li,Liu Yong,Hu Ya-hua,Peng Peng,Wang Jian-ming,Liu Ji-yang,Chen Zhong,Li Gang,Zheng Zhi-jian,Qiu Shao-qin,Luo Jie,Ye Chang-jiang,Zhu Shao-yong,Cheng Lin-ling,Ye Feng,Li Shi-yue,Zheng Jin-ping,Zhang Nuo-fu,Zhong Nan-shan,He Jian-xing

Abstract

BackgroundThe coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide.ObjectiveTo evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status.MethodsWe 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.ResultsThe 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.ConclusionAmong 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.

Funder

National Health Commission

Guangdong Science and Technology Department

Publisher

European Respiratory Society (ERS)

Subject

Pulmonary and Respiratory Medicine

Reference36 articles.

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