Association of comorbidities with COVID-19 infection rate and severity: a nationwide cohort study with propensity score matching (Preprint)

Abstract

Confirming the relationship between comorbidities and coronavirus infection-19 (COVID-19) is important for efficient use of medical facilities.

This study investigated the impact of patient demographics and comorbidities on the infection rate and severity of COVID-19.

Data were derived from a Korean nationwide cohort study with propensity score matching. We included 8070 individuals with positive covid-19 test and 12015 controls between January 1, 2020, and May 30, 2020. Outcomes were confirmation of the comorbidities affecting the infection rate and the severity of COVID-19. Endpoints were COVID-19 positivity and severe clinical outcomes of COVID-19 (tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, or death).

In people aged 60 or older, in those insured with Medicaid, and in the disabled, the proportion corresponding to the severe group of patients showed a tendency to increase. The infection rate of COVID-19 was highest in pulmonary disease (adjusted odds ratio 1.88, 95% confidence interval 1.70 to 2.03), and hyperlipidemia (0.73, 0.67 to 0.80) had a lower infection rate. Disease severity was highest in kidney disease (5.59, 2.48 to 12.63), and lower in hyperlipidemia (0.78, 0.60 to 1.00).

Using propensity matching to reduce statistical bias, we found that most comorbidities increased the infection rate and severity of COVID-19, whereas hyperlipidemia reduced the rate and severity of infection.

RR2-https://doi.org/10.1101/2021.09.22.21263946