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

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 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.

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Affiliated Institutions

• Guangzhou Medical University CN
• Jinyintan Hospital CN
• Huangshi Central Hospital CN
• Southern Medical University CN
• First Affiliated Hospital of Guangzhou Medical University CN
• The First Hospital of Changsha CN
• Sun Yat-sen University CN
• Second Hospital of Yichang CN
• Fifth Affiliated Hospital of Sun Yat-sen University CN
• Guangzhou Eighth People's Hospital CN
• Wuhan Pulmonary Hospital CN
• Hubei Polytechnic University CN
• Wuhan University of Science and Technology CN
• Hubei University of Medicine CN
• Sanya Central Hospital CN
• Shenzhen Third People’s Hospital CN
• Public Health Clinical Center of Chengdu CN
• Third Affiliated Hospital of Guangzhou Medical University CN
• The First People's Hospital of Wenling CN
• Huanggang Central Hospital CN
• State Key Laboratory of Respiratory Disease CN
• Wuhan No.1 Hospital CN
• Taihe Hospital CN
• Wuhan Union Hospital CN
• Southern University of Science and Technology CN
• Central Hospital of Wuhan CN

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