Unravelling the complex interplay of age, comorbidities, and multimorbidities in COVID-19 disease progression:
Maria Shoukat1,2, Haseeb Khan1, Wajid Munir3
1Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.
Insights
Age and comorbidities significantly impact COVID-19 severity and mortality. Patients with multiple health conditions, especially older adults, face higher risks, underscoring the need for tailored management strategies.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- COVID-19 presents significant global health challenges due to multi-factor risks.
- Understanding age and comorbidity effects is crucial for managing disease severity and mortality, particularly in resource-limited settings.
Purpose of the Study:
- To assess comorbidity prevalence across age groups in hospitalized COVID-19 patients.
- To evaluate the impact of age and comorbidities on COVID-19 disease severity and mortality rates.
Main Methods:
- A retrospective study analyzed 618 hospitalized COVID-19 patients.
- Data collected included patient demographics, comorbidities, and clinical outcomes (ventilation needs, ICU admission, survival).
Main Results:
- Age showed a significant association with disease prevalence (p < 0.001).
- Comorbidities (hypertension, diabetes, IHD, asthma, CKD, TB) were present in 63.9% of patients.
- Comorbidities and older age (≥65 years) significantly increased the need for ventilation and ICU admission (p < 0.001).
- Patients without comorbidities had the highest survival rates.
- Multimorbidities (e.g., DM/HTN/IHD) were linked to lower survival and higher mortality (p < 0.001).
Conclusions:
- Age and comorbidities significantly influence COVID-19 severity and mortality.
- Effective management strategies for COVID-19 and other infectious respiratory diseases must consider these patient-specific factors.
Introduction:
The COVID-19 infection as an inflammatory disease has posed significant challenges to global public health due to multi-factor risks associated with it leading to disease severity and mortality. Understanding the effect of age and comorbidities on overall disease progression is crucial to identify highly susceptible individuals and to develop effective disease management strategies in a resource limited country like Pakistan.
Methodology:
A retrospective study was conducted on hospitalized COVID-19 patients to assess the prevalence of various comorbidities among different age groups and their effect on disease severity and mortality rate.
Results:
In this retrospective study, a cohort of 618 hospitalized COVID-19 patients was analyzed, consisting of 387 males (62.6 %) and 231 females (37.4 %). Notably, the young age group (15-24 years), had the lowest frequency of hospitalized COVID-19 patients, while no case was observed in children (≤14 years) showing a significant association (p < 0.001) of age and disease prevalence. Comorbidities were observed in 63.9 % of COVID-19 patients including hypertension (HTN), diabetes mellitus (DM), ischemic heart diseases (IHD), asthma, chronic kidney disease (CKD) and tuberculosis (TB). The most common comorbidities were HTN (42.1 %) followed by DM (33.8 %), IHD (16.5 %), asthma (11.2 %), CKD (7.9 %) and TB (1.9 %).Furthermore, the study revealed a significant association between comorbidities, age groups, and the need for non-invasive ventilation (NIV) (p < 0.001), mechanical ventilation (MV) (p < 0.001), and intensive care unit (ICU) admission (p < 0.001). Patients with specific comorbidities and those in the older age group (≥65 years) demonstrated a higher need for these interventions. However, patients without any comorbidity consistently exhibited the highest cumulative proportion of survival at each time point, indicating better overall survival outcomes. In contrast, patients with multimorbidities of DM/HTN/IHD, HTN/IHD, and DM/HTN/CKD had comparatively lower survival rates and higher mortality rates (p < 0.001).
Conclusion:
This research highlights the significant impact of age, comorbidities and multimorbidities on the severity and mortality of COVID-19 patients. It highlights the importance of considering these factors in tailoring effective management strategies for patients with COVID-19 or other infectious respiratory diseases.
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