Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis

Eur Respir J. 2020 May 14;55(5):2000547. doi: 10.1183/13993003.00547-2020. Print 2020 May.

Abstract

Background: The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide.

Objective: To evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status.

Methods: We analysed data from 1590 laboratory confirmed hospitalised patients from 575 hospitals in 31 provinces/autonomous regions/provincial municipalities across mainland China between 11 December 2019 and 31 January 2020. We analysed the composite end-points, which consisted of admission to an intensive care unit, invasive ventilation or death. The risk of reaching the composite end-points was compared according to the presence and number of comorbidities.

Results: The mean age was 48.9 years and 686 (42.7%) patients were female. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached the composite end-points. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD (HR (95% CI) 2.681 (1.424-5.048)), diabetes (1.59 (1.03-2.45)), hypertension (1.58 (1.07-2.32)) and malignancy (3.50 (1.60-7.64)) were risk factors of reaching the composite end-points. The hazard ratio (95% CI) was 1.79 (1.16-2.77) among patients with at least one comorbidity and 2.59 (1.61-4.17) among patients with two or more comorbidities.

Conclusion: Among laboratory confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • China / epidemiology
  • Comorbidity
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Prognosis
  • Risk Factors
  • SARS-CoV-2