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


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


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.


National Health Commission

Guangdong Science and Technology Department


European Respiratory Society (ERS)


Pulmonary and Respiratory Medicine

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