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Effect of Underlying Comorbidities on the Infection and Severity of COVID-19 in Korea: a Nationwide Case-Control
Wonjun Ji1, Kyungmin Huh2, Minsun Kang3
1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Insights
Certain comorbidities like diabetes and schizophrenia increase COVID-19 risk. These conditions, along with hypertension and chronic renal failure, are also linked to severe coronavirus disease 2019 (COVID-19) outcomes.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- The COVID-19 pandemic presents a global health challenge.
- Understanding the impact of pre-existing conditions on COVID-19 risk and severity is crucial.
Purpose of the Study:
- To investigate the association between various comorbidities and the likelihood of contracting COVID-19.
- To determine which comorbidities are linked to increased severity of COVID-19.
Main Methods:
- A nationwide retrospective case-control study involving 219,961 adults was conducted.
- COVID-19 diagnosis and severity (based on respiratory support) were identified from medical reimbursement data.
- Multiple logistic regression analysis was used to estimate odds ratios, adjusting for demographic and healthcare utilization factors.
Main Results:
- Diabetes, osteoporosis, rheumatoid arthritis, substance use, and schizophrenia were significantly associated with a higher risk of COVID-19 infection.
- Diabetes, hypertension, chronic lower respiratory disease, and chronic renal failure (including end-stage renal disease) were associated with increased COVID-19 severity.
Conclusions:
- Several comorbidities are confirmed to be associated with both COVID-19 infection and its severity.
- Healthcare providers should exercise heightened vigilance when managing COVID-19 patients with identified comorbidities.
Background:
The coronavirus disease 2019 (COVID-19) pandemic is an emerging threat worldwide. It remains unclear how comorbidities affect the risk of infection and severity of COVID-19.
Methods:
This is a nationwide retrospective case-control study of 219,961 individuals, aged 18 years or older, whose medical costs for COVID-19 testing were claimed until May 15, 2020. COVID-19 diagnosis and infection severity were identified from reimbursement data using diagnosis codes and on the basis of respiratory support use, respectively. Odds ratios (ORs) were estimated using multiple logistic regression, after adjusting for age, sex, region, healthcare utilization, and insurance status.
Results:
The COVID-19 group (7,341 of 219,961) was young and had a high proportion of female. Overall, 13.0% (954 of 7,341) of the cases were severe. The severe COVID-19 group had older patients and a proportion of male ratio than did the non-severe group. Diabetes (odds ratio range [ORR], 1.206-1.254), osteoporosis (ORR, 1.128-1.157), rheumatoid arthritis (ORR, 1.207-1.244), substance use (ORR, 1.321-1.381), and schizophrenia (ORR, 1.614-1.721) showed significant association with COVID-19. In terms of severity, diabetes (OR, 1.247; 95% confidential interval, 1.009-1.543), hypertension (ORR, 1.245-1.317), chronic lower respiratory disease (ORR, 1.216-1.233), chronic renal failure, and end-stage renal disease (ORR, 2.052-2.178) were associated with severe COVID-19.
Conclusion:
We identified several comorbidities associated with COVID-19. Health care workers should be more careful while diagnosing and treating COVID-19 when patients have the abovementioned comorbidities.
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