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Comorbidities and outcomes among patients hospitalized with COVID-19 in Upper Egypt
Eman M Khedr1,2,3, Enas Daef4, Aliae Mohamed-Hussein5
1Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt.
Insights
COVID-19 patients with comorbidities, especially cardiovascular diseases, face worse outcomes, including higher ICU admission rates and mortality. These conditions significantly increase the risk of severe illness and death in coronavirus disease 19 patients.
Area of Science:
- Infectious Diseases
- Epidemiology
- Internal Medicine
Background:
- The COVID-19 pandemic has caused significant global morbidity and mortality.
- Comorbidities are recognized risk factors for severe COVID-19 outcomes.
- Understanding comorbidity impact is crucial for patient management.
Purpose of the Study:
- To evaluate the impact of comorbidities on COVID-19 patient outcomes.
- To identify predictors of prolonged hospitalization and ICU admission in COVID-19 patients.
Main Methods:
- A study of 439 adult COVID-19 patients admitted between June and July 2020.
- Data collected on patient demographics, symptoms, laboratory parameters, and outcomes.
- Comparison of outcomes between patients with and without comorbidities.
Main Results:
- 61.7% of COVID-19 patients had comorbidities, experiencing more constitutional and lower respiratory tract symptoms.
- Patients with comorbidities showed worse laboratory parameters, higher ICU admission rates (35.8%), and increased need for mechanical ventilation.
- COVID-19 patients with comorbidities had significantly lower recovery rates (59% vs. 81%) and higher mortality.
Conclusions:
- Cardiovascular diseases and neurological conditions significantly increase COVID-19 mortality risk.
- Diabetes mellitus, chronic pulmonary, and kidney diseases may also worsen COVID-19 severity.
- Comorbidities are critical factors influencing COVID-19 prognosis and severity.
Background:
The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 had consistently been reported as risk factors for unfavorable outcome. We aimed to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for intensive care unit (ICU) admission. Four hundred and thirty-nine adult patients who are admitted through (June and July 2020) in our 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.
Results:
Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and lower respiratory tract (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 cardiovascular diseases (CVD) cases were admitted in ICU followed by diabetes mellitus (DM) cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 versus 10.7%, P < 0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% versus 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).
Conclusions:
Association of cardiovascular comorbid conditions including hypertension or neurological diseases including old cerebrovascular strokes 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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