Prevalence of comorbidities and its impacts in Hospitalized patients with COVID-19
Keywords:comorbidities, COVID-19, Hospitalized patients
Objective: The purpose of this study is to evaluate the prevalence of comorbidities in hospitalized COVID-19 patients and its effects on the severity of the disease. The coronavirus pandemic has been a challenging problem for health care systems since December 2019.
Methods: This was a retrospective, cross-sectional study analyzing data related to the epidemiological characteristics of COVID-19 patients admitted to Razi Hospital in Ahvaz, Iran from November 2020 to February 2021. The data on patient demographic characteristics including age, gender, and underlying diseases were collected from patient records. Patients whose data were unavailable or incomplete were excluded from the study.
Results: The mean age of all of the 730 patients studied was 56.30Â±16.36 years, and 53.7% of them were men. Nearly 40% of the patients reported more than one comorbidity, with diabetes mellitus being the most frequent one (37.5%) followed by hypertension (35.3%) and ischemic heart disease (24.9). In addition, 21.5% of the patients required intensive care unit admission. Finally, 11.9% of the patients had respiratory distress and became intubated, and approximately 13.6% of the patients died. Hyperlipidemia, liver failure, tuberculosis, and elevated inflammatory biomarkers are risk factors for ICU admission and death.
Conclusion: we found that male gender, older age, hyperlipidemia, liver failure, TB, having more than one comorbidity, and elevated inflammatory biomarkers were significantly associated with the risk of severe COVID-19 disease.
2. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical infectious diseases. 2020;71(15):762-8.
3. Guan W-j, Liang W-h, Zhao Y, Liang H-r, Chen Z-s, Li Y-m, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. European Respiratory Journal. 2020;55(5).
4. Liu K, Fang Y-Y, Deng Y, Liu W, Wang M-F, Ma J-P, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chinese medical journal. 2020.
5. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. 2020;323(13):1239-42.
6. Zhong N, Zheng B, Li Y, Poon L, Xie Z, Chan K, et al. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People's Republic of China, in February, 2003. The Lancet. 2003;362(9393):1353-8.
7. Assiri A, McGeer A, Perl TM, Price CS, Al Rabeeah AA, Cummings DA, et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. New England Journal of Medicine. 2013;369(5):407-16.
8. Choi KW, Chau TN, Tsang O, Tso E, Chiu MC, Tong WL, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Annals of internal medicine. 2003;139(9):715-23.
9. Hong K-H, Choi J-P, Hong S-H, Lee J, Kwon J-S, Kim S-M, et al. Predictors of mortality in Middle East respiratory syndrome (MERS). Thorax. 2018;73(3):286-9.
10. Koff WC, Williams MA. Covid-19 and immunity in aging populationsâ€”a new research agenda. New England Journal of Medicine. 2020;383(9):804-5.
11. Zaferani Arani H, Dehghan Manshadi G, Atashi HA, Rezaei Nejad A, Ghorani SM, Abolghasemi S, et al. Understanding the clinical and demographic characteristics of second coronavirus spike in 192 patients in Tehran, Iran: A retrospective study. Plos one. 2021;16(3):e0246314.
12. Pijls BG, Jolani S, Atherley A, Derckx RT, Dijkstra JI, Franssen GH, et al. Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies. BMJ open. 2021;11(1):e044640.
13. Oudit GY, Pfeffer MA. Plasma angiotensin-converting enzyme 2: novel biomarker in heart failure with implications for COVID-19. European heart journal. 2020;41(19):1818-20.
14. Yazdanpanah L, Shahbazian H, Aleali AM, Jahanshahi A, Ghanbari S, Latifi S. Prevalence, awareness and risk factors of diabetes in Ahvaz (South West of Iran). Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2016;10(2):S114-S8.
15. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(4):303-10.
16. Yazdanpanah L, Shahbazian H, Shahbazian H, Latifi S-M. Prevalence, awareness and risk factors of hypertension in southwest of Iran. Journal of renal injury prevention. 2015;4(2):51.
17. Latifi SM, Moradi L, Shahbazian H, Aleali AM. A study of the prevalence of dyslipidemia among the adult population of Ahvaz, Iran. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2016;10(4):190-3.
18. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020;395(10229):1054-62.
19. Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY). 2020;12(13):12493.
20. Zhang G, Hu C, Luo L, Fang F, Chen Y, Li J, et al. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. Journal of Clinical Virology. 2020;127:104364.
21. Du R-H, Liang L-R, Yang C-Q, Wang W, Cao T-Z, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. European Respiratory Journal. 2020;55(5).
22. Abrishami A, Khalili N, Dalili N, Tabari RK, Farjad R, Samavat S, et al. Clinical and radiologic characteristics of COVID-19 in patients with CKD. Iranian journal of kidney diseases. 2020;14(4):267-77.
23. Meng J, Xiao G, Zhang J, He X, Ou M, Bi J, et al. Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension. Emerging microbes & infections. 2020;9(1):757-60.
24. Chen T, Dai Z, Mo P, Li X, Ma Z, Song S, et al. Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China: a single-centered, retrospective study. The Journals of Gerontology: Series A. 2020;75(9):1788-95.
25. Wu B, Zhou J, Wang W, Yang H, Xia M, Zhang B, et al. Association Analysis of Hyperlipidemia with the 28-Day All-Cause Mortality of COVID-19 in Hospitalized Patients. Chinese Medical Sciences Journal. 2021;36(1):17-26.