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The Role of Comorbidities in COVID-19 Severity
Sandra König1, Ugne Vaskyte1,2, Maria Boesing1,2
1University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland.
Insights
Comorbidities like obesity, diabetes, and hypertension significantly increase critical COVID-19 outcomes in hospitalized patients. Patients without comorbidities experienced the lowest rates of severe disease and complications.
Area of Science:
- Infectious Diseases
- Epidemiology
- Internal Medicine
Background:
- COVID-19 causes significant global morbidity and mortality.
- Understanding comorbidity impact on COVID-19 outcomes is crucial for patient management.
- Limited data exists on comorbidities affecting COVID-19 severity in diverse Swiss cohorts across multiple outbreak waves.
Purpose of the Study:
- To explore the role of comorbidities on COVID-19 severity in hospitalized patients.
- To evaluate the association between comorbidities and specific in-hospital complications in a Swiss cohort.
Main Methods:
- Retrospective, observational, single-center study at Cantonal Hospital Baselland, Switzerland (March 2020 - December 2021).
- Included 1124 adult patients hospitalized for COVID-19.
- Logistic regression analyses adjusted for age and gender assessed associations between comorbidities and critical condition/complications.
Main Results:
- 76% of patients had at least one comorbidity; common ones included hypertension (47%), obesity (27%), and diabetes (24%).
- Obesity, diabetes, hypertension, arrhythmia, and COPD were associated with critical COVID-19 condition.
- Patients without comorbidities had significantly lower rates of critical condition (5.3%) and complications (10.2%).
Conclusions:
- Specific comorbidities are key risk factors for critical COVID-19 outcomes, aligning with previous research.
- Asthma showed the least impact on COVID-19 disease severity among evaluated comorbidities.
- Future research should investigate combined comorbidity effects and long-term COVID-19 outcomes in patients with specific comorbidities.
Background:
COVID-19 has led to significant global morbidity and mortality, with clinical outcomes varying widely among individuals. Understanding the impact of comorbidities on COVID-19 outcomes is essential for improving patient management. To date, analyses of comorbidities affecting COVID-19 severity in a heterogeneous Swiss cohort across multiple outbreak waves are unavailable. The objective of this study was to explore the role of comorbidities on COVID-19 severity in hospitalized patients from a diverse Swiss cohort and to evaluate the association between comorbidities and specific in-hospital complications.
Methods:
This retrospective, observational, single-center study included adult patients who were hospitalized for COVID-19 for at least one night at the Cantonal Hospital Baselland, Switzerland (KSBL), between March 2020 and December 2021. Logistic regression analyses adjusted for age and gender were performed to analyze the association between comorbidities and critical condition (defined as severe disease or in-hospital death) and complications.
Results:
A total of 1124 patients were included in the study (median age 66, range 19-100 years, 60% male). A total of 76% of patients had at least one comorbidity. The most common comorbidities were arterial hypertension (47%), obesity (27%), and diabetes mellitus (24%). Overall, 16% of patients experienced a critical condition, and 25.5% had any type of complication. Patients without comorbidities had the lowest rates of critical condition (5.3%) and complications (10.2%). Obesity (OR 2.01, p < 0.001), diabetes mellitus (OR 1.67, p = 0.004), arterial hypertension (OR 1.65, p = 0.006), arrhythmia (OR1.87, p = 0.003), and chronic obstructive pulmonary disease (OR 2.72, p < 0.001) were found to be associated with critical condition. The most frequently observed complication was acute kidney failure, affecting 17.1% of the study population, while patients with arrhythmia showed the highest overall complication rate (42%).
Conclusions:
Our findings are consistent with previous research, confirming the relevance of specific comorbidities as key risk factors for critical COVID-19 outcomes. Among all comorbid conditions evaluated, asthma appeared to have the least impact on disease severity. Future research should focus on the impact of the combination of comorbidities on the disease severity of COVID-19, as well as the long-term effects of COVID-19 for patients with certain comorbidities.
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