The Effect of Comorbidities and Complications on COVID-19 Mortality: A Detailed Retrospective Study in Western Romania
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Updated: Jul 10, 2025
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Published on: November 10, 2023
Monica Steluta Marc1,2, Daniela Rosca3, Felix Bratosin3,4
1Center for Research and Innovation in Precision Medicine of Respiratory Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Insights
COVID-19 survivors with comorbidities like type 2 diabetes mellitus face higher mortality. Tracheostomy and pneumothorax significantly increase death risk, while some hypertension and obesity may offer protection. Personalized care is crucial.
Area of Science:
- Infectious Diseases
- Public Health
- Clinical Medicine
Background:
- COVID-19 continues to pose long-term health challenges, especially for individuals with pre-existing conditions.
- Comorbidities and complications significantly influence the survival outcomes of COVID-19 patients.
- Understanding these associations is vital for improving post-pandemic healthcare strategies.
Purpose of the Study:
- To investigate the relationship between comorbidities, complications, and survival rates in COVID-19 survivors in Western Romania.
- To identify specific risk factors and protective elements affecting mortality.
- To inform clinical management and public health policy.
Main Methods:
- Retrospective analysis of 192 COVID-19 survivors from January to December 2021.
- Classification of COVID-19 severity based on World Health Organization (WHO) guidelines.
- Statistical analysis to determine the impact of comorbidities and complications on mortality.
Main Results:
- Tracheostomy was associated with a significantly higher mortality rate (83.3% vs. 22.2%, p < 0.001).
- Pneumothorax (OR 22.11) and type 2 diabetes mellitus (univariate OR 2.89) increased mortality risk.
- Grade I hypertension and grade II obesity appeared to have a protective effect against mortality.
Conclusions:
- Comorbidities and complications are significant determinants of survival in COVID-19 survivors.
- Tracheostomy, pneumothorax, and type 2 diabetes mellitus are critical risk factors for mortality.
- Personalized patient care and targeted healthcare policies are essential for managing COVID-19 sequelae.
Abstract:
COVID-19 continues to impact global health systems even after being declared over, with some patients exhibiting severe complications linked to pre-existing conditions. This study aimed to investigate the association between comorbidities, complications, and survival outcomes among COVID-19 survivors in Western Romania. Our hypothesis posited that comorbidities and complications significantly influence survival rates. We conducted a retrospective analysis of 1948 COVID-19 survivors admitted from January to December 2021, with 192 selected for detailed analysis based on inclusion and exclusion criteria. The severity of COVID-19 was classified according to WHO guidelines, and conditions like hypertension and obesity were defined using criteria from the European Society of Hypertension (ESH), the European Society of Cardiology (ESC), and WHO, respectively. Among the 192 patients, 33 had mild, 62 had moderate, and 97 had severe COVID-19. The median age across the severity groups was 63.2 years. Patients undergoing tracheostomy had a mortality rate of 83.3% versus 22.2% for non-tracheostomy patients (p < 0.001) and presented with significantly higher lung injury, hospitalization duration, and complications. Remarkably, tracheostomized patients were 17.50 times more likely to succumb to the disease (95% CI 4.39-116.91, p < 0.001). Furthermore, pneumothorax increased the mortality risk significantly (OR 22.11, 95% CI 5.72-146.03, p < 0.001). Intriguingly, certain conditions like grade I hypertension and grade II obesity showed a protective effect against mortality, whereas type 2 diabetes mellitus increased mortality risk (univariate OR 2.89, p = 0.001). The presence of certain comorbidities and complications significantly impacts the survival rates of COVID-19 patients in Western Romania. Notably, tracheostomy, pneumothorax, and T2DM were associated with increased mortality. This study underscores the importance of personalized patient care and provides insights for healthcare policymakers in Western Romania to improve clinical management strategies.
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