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Impact of comorbidities on COVID-19 outcome

Eman M Khedr, Enas Daef, Aliae Mohamed-Hussein

Medrxiv : the Preprint Server for Health Sciences

|May 20, 2021

Insights

Comorbidities significantly worsen COVID-19 outcomes, increasing mortality and ICU admissions. Cardiovascular and neurological conditions pose the highest risks for severe COVID-19 disease.

Area of Science:

Infectious Diseases
Public Health
Internal Medicine

Background:

The COVID-19 pandemic has caused significant global morbidity and mortality.
Comorbidities are recognized risk factors for poor COVID-19 prognosis.
Understanding comorbidity impact is crucial for patient management.

Conclusions:

Cardiovascular and neurological comorbidities are strongly associated with increased COVID-19 mortality.
Diabetes mellitus, chronic pulmonary, and kidney diseases also contribute to COVID-19 severity.
Managing comorbidities is essential for improving COVID-19 patient outcomes.

Read full analysis

Abstract

Background And Aims:

The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 have consistently been reported as risk factors for unfavorable prognosis. We aim at this study to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for ICU admission or decease.

Methods:

Four hundreds and thirty nine adult patients who are admitted through (June and July 2020) in Assiut and Aswan University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or Probable case. Detection of SARS-CoV-2 RNA was done by (TaqManâ"¢ 2019-nCoV Control Kit v1 (Cat. No. A47532) supplied by QIAGEN, Germany on the Applied Biosystem 7500 Fast RT PCR System, USA.

Results:

Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and LRT symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of CVD cases were admitted in ICU followed by DM cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 vs. 10.7%, P<0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% vs. 81%, P<0.001) and death rate was significantly higher in cases with comorbidities (P< 0.001). The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P<0.002 and 0.001 respectively).

Conclusion:

Association of cardiovascular comorbid conditions including hypertension or neurological diseases together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.

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