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Published on: November 10, 2023
The potential association between common comorbidities and severity and mortality of coronavirus disease 2019: A
Liman Luo1,2,3, Menglu Fu1,3, Yuanyuan Li1,3
1Department of Geriatric Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Insights
Comorbidities and cardiac injury significantly worsen prognosis for COVID-19 patients. Monitoring organ injury indicators and managing comorbidities are crucial for improving outcomes in coronavirus disease 2019 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Investigated the link between pre-existing conditions and cardiac issues in COVID-19 patients.
- Assessed the impact of comorbidities and cardiac injury on coronavirus disease 2019 prognosis.
Purpose of the Study:
- To determine if underlying comorbidities and cardiac injury are associated with prognosis in COVID-19 patients.
- To evaluate the risk of severity and mortality in coronavirus disease 2019 patients with various comorbidities and cardiac injury.
Main Methods:
- Systematic literature search across major databases (PubMed, EMBASE, Web of Science, Cochrane Library) from December 2019 to July 2020.
- Utilized odds ratios (OR) and 95% confidence intervals (95% CI) to quantify associations.
- Analyzed data from 124 included studies.
Main Results:
- COVID-19 patients with comorbidities faced a higher risk of severity and mortality.
- Specific comorbidities like hypertension, diabetes, cardiovascular diseases, COPD, CKD, and cancer showed significantly increased risks.
- Acute cardiac injury was more prevalent in severe cases and linked to higher in-hospital mortality.
Conclusions:
- Both comorbidities and acute cardiac injury are strongly associated with poor prognosis in coronavirus disease 2019.
- Continuous monitoring of organ injury markers and attention to comorbidities are essential for managing COVID-19 patients.
Backgroud:
The association between underlying comorbidities and cardiac injury and the prognosis in coronavirus disease 2019 (COVID-19) patients was assessed in this study.
Hypothesis:
The underlying comorbidities and cardiac injury may be associated with the prognosis in COVID-19 patients.
Methods:
A systematic search was conducted in PubMed, EMBASE, Web of science, and The Cochrane library from December 2019 to July 2020. The odds ratio (OR) and 95% confidence intervals (95% CI) were used to estimate the probability of comorbidities and cardiac injury in COVID-19 patients with or without severe type, or in survivors vs nonsurvivors of COVID-19 patients.
Results:
A total of 124 studies were included in this analysis. A higher risk for severity was observed in COVID-19 patients with comorbidities. The pooled result in patients with hypertension (OR 2.57, 95% CI: 2.12-3.11), diabetes (OR 2.54, 95% CI: 1.89-3.41), cardiovascular diseases (OR 3.86, 95% CI: 2.70-5.52), chronic obstractive pulmonary disease (OR 2.71, 95% CI: 1.98-3.70), chronic kidney disease (OR 2.20, 95% CI: 1.27-3.80), and cancer (OR 2.42, 95% CI: 1.81-3.22) respectively. All the comorbidities presented a higher risk of mortality. Moreover, the prevalence of acute cardiac injury is higher in severe group than in nonsevere group, and acute cardiac injury is associated with an increased risk for in-hospital mortality.
Conclusion:
Comorbidities and acute cardiac injury are closely associated with poor prognosis in COVID-19 patients. It is necessary to continuously monitor related clinical indicators of organs injury and concern comorbidities in COVID-19 patients.
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