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The Relationship Between Predisposing Risk Factors and COVID-19: An Observational Study
Ramnivas Vishnoi1, Manish Gaba1, Naveen Kumar1
1Internal Medicine, Max Smart Super Speciality Hospital, New Delhi, IND.
Insights
The number of comorbidities significantly increases COVID-19 severity and mortality risk. Identifying patients with multiple risk factors allows for early intervention to improve outcomes.
Area of Science:
- Internal Medicine
- Epidemiology
- Public Health
Background:
- Numerous risk factors, including sociodemographic variables and comorbidities, are linked to severe COVID-19.
- Individuals with conditions like diabetes, hypertension, and heart disease face higher risks of severe illness and death.
- Understanding these associations is crucial for managing COVID-19 patient outcomes.
Purpose of the Study:
- To investigate the association between various risk factors and the severity of COVID-19.
- To analyze how the number of comorbidities impacts disease progression and outcomes.
- To identify patient groups requiring prioritized medical attention.
Main Methods:
- A prospective, observational, single-center study involving 1,454 hospitalized patients.
- Patients were categorized into groups based on the absence, single, or multiple comorbidities.
- Risk factors evaluated included age, obesity, diabetes, hypertension, chronic kidney disease (CKD), heart disease, chronic liver disease (CLD), and immunocompromised status.
Main Results:
- A significant association was observed between increasing age, male gender, and COVID-19 severity.
- Comorbidities such as diabetes, hypertension, obesity, CKD, CLD, and heart disease were strongly linked to severe disease.
- Disease severity and mortality increased significantly with the number of comorbidities present.
Conclusions:
- The severity of COVID-19 correlates directly with the number of coexisting risk factors.
- Patients with multiple comorbidities represent a high-risk group requiring proactive management strategies.
- Early identification and intervention in these vulnerable populations can mitigate severe disease and improve survival rates.
Abstract:
Background Numerous risk factors have been identified for developing severe COVID-19, including sociodemographic variables and concomitant diseases. Individuals with underlying comorbidities such as diabetes, hypertension, asthma, and coronary artery disease are at a greater risk of severe illness and death. This study aimed to observe the association between risk factors and the severity of COVID-19. Methodology A single-center, hospital-based, prospective, observational study was conducted at Max Smart Super Speciality Hospital in Saket, Delhi from October 2020 to December 2021. A total of 1,454 patients admitted under our care in the Department of Internal Medicine were included in this study. Patients were divided into the following three groups: patients without comorbidities, patients with a single comorbidity, and patients with multiple comorbidities. The risk factors under evaluation were age >50 years, obesity, diabetes, hypertension, chronic kidney disease (CKD), heart disease, chronic liver disease (CLD), and immunocompromised status (human immunodeficiency virus, post-transplant, malignancy undergoing chemotherapy). Results In this study, 28.1% (n = 408) of patients did not have comorbidities, 30.1% (n = 438) of patients had a single comorbidity, and 41.8% (n = 608) of patients had multiple comorbidities. Regarding risk factors, 62% (n = 872) of patients were aged >50 years, 7.4% (n = 108) were obese, 30.7% (n = 447) had diabetes, 33% (n = 480) were hypertensive, 1.2% (n = 18) had CKD, 6.8% (n = 99) had heart disease, 0.3% (n = 4) had CLD, and 5.5% (n = 80) were immunocompromised. A statistically significant association was found between increasing age and worsening severity of COVID-19 (p = 0.0001), male gender (p = 0.0001), presence of comorbidities, including diabetes, hypertension, obesity, CKD, CLD, heart disease (p = 0.0001). Patients in the immunocompromised group did not have a statistically significant association with disease severity. A statistically significant association was found between mortality and severity of COVID-19. Overall, 16.7% (n = 48) of the patients in the no comorbidity group, 35.4% (n = 102) in the single comorbidity group, and 47.9% (n = 138) in the multiple comorbidity group (p = 0.0001) presented with severe disease on admission. Conclusions The study shows that the severity of the disease increased as the number of risk factors increased. This information can help us take early and active measures in these groups of patients with multiple comorbid illnesses.
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