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Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis.
Guan, Wei-Jie; Liang, Wen-Hua; Zhao, Yi; Liang, Heng-Rui; Chen, Zi-Sheng; Li, Yi-Min; Liu, Xiao-Qing; Chen, Ru-Chong; Tang, Chun-Li; Wang, Tao; Ou, Chun-Quan; Li, Li; Chen, Ping-Yan; Sang, Ling; Wang, Wei; Li, Jian-Fu; Li, Cai-Chen; Ou, Li-Min; Cheng, Bo; Xiong, Shan; Ni, Zheng-Yi; Xiang, Jie; Hu, Yu; Liu, Lei; Shan, Hong; Lei, Chun-Liang; Peng, Yi-Xiang; Wei, Li; Liu, Yong; Hu, Ya-Hua; Peng, Peng; Wang, Jian-Ming; Liu, Ji-Yang; Chen, Zhong; Li, Gang; Zheng, Zhi-Jian; Qiu, Shao-Qin; Luo, Jie; Ye, Chang-Jiang; Zhu, Shao-Yong; Cheng, Lin-Ling; Ye, Feng; Li, Shi-Yue; Zheng, Jin-Ping; Zhang, Nuo-Fu; Zhong, Nan-Shan; He, Jian-Xing.
  • Guan WJ; State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Liang WH; These authors are joint first authors.
  • Zhao Y; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Liang HR; These authors are joint first authors.
  • Chen ZS; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Li YM; These authors are joint first authors.
  • Liu XQ; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Chen RC; These authors are joint first authors.
  • Tang CL; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Wang T; The sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China.
  • Ou CQ; These authors are joint first authors.
  • Li L; Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Chen PY; Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Sang L; State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Wang W; State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Li JF; State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Li CC; State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
  • Ou LM; State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
  • Cheng B; State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
  • Xiong S; Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Ni ZY; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Xiang J; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Hu Y; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Liu L; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Shan H; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Lei CL; Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Peng YX; Wuhan Jin-yintan Hospital, Wuhan, China.
  • Wei L; Wuhan Jin-yintan Hospital, Wuhan, China.
  • Liu Y; Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Hu YH; Shenzhen Third People's Hospital, Shenzhen, China.
  • Peng P; The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, China.
  • Wang JM; The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
  • Liu JY; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Chen Z; The Central Hospital of Wuhan, Wuhan, China.
  • Li G; Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China.
  • Zheng ZJ; Chengdu Public Health Clinical Medical Center, Chengdu, China.
  • Qiu SQ; Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China.
  • Luo J; Wuhan Pulmonary Hospital, Wuhan, China.
  • Ye CJ; Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
  • Zhu SY; The First Hospital of Changsha, Changsha, China.
  • Cheng LL; The Third People's Hospital of Hainan Province, Sanya, China.
  • Ye F; Huanggang Central Hospital, Huanggang, China.
  • Li SY; Wenling First People's Hospital, Wenling, China.
  • Zheng JP; The Third People's Hospital of Yichang, Yichang, China.
  • Zhang NF; Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, China.
  • Zhong NS; Xiantao First People's Hospital, Xiantao, China.
  • He JX; The People's Hospital of Huangpi District, Wuhan, China.
Eur Respir J ; 55(5)2020 05.
Article in English | MEDLINE | ID: covidwho-18269
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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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Year: 2020 Document Type: Article Affiliation country: 13993003.00547-2020

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Year: 2020 Document Type: Article Affiliation country: 13993003.00547-2020