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

Wei-jie Guan, Wen-hua Liang, Yi Zhao, Heng-rui Liang, Zi-sheng Chen, Yi-min Li, Xiao-qing Liu, Ru-chong Chen, Chun-li Tang, Tao Wang, Chun-quan Ou, Li Li, Ping-yan Chen, Ling Sang, Wei Wang, Jian-fu Li, Cai-chen Li, Li-min Ou, Bo Cheng, Shan Xiong, Zheng-yi Ni, Jie Xiang, Yu Hu, Lei Liu, Hong Shan, Chun-liang Lei, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Lin-ling Cheng, Feng Ye, Shi-yue Li, Jin-ping Zheng, Nuo-fu Zhang, Nan-shan Zhong, Jian-xing He on behalf of the China Medical Treatment Expert Group for COVID-19
European Respiratory Journal 2020 55: 2000547; DOI: 10.1183/13993003.00547-2020
Wei-jie Guan
1State 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
26These authors are joint first authors
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Wen-hua Liang
2Dept 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
26These authors are joint first authors
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Yi Zhao
2Dept 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
26These authors are joint first authors
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Heng-rui Liang
2Dept 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
26These authors are joint first authors
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Zi-sheng Chen
2Dept 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
3The sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China
26These authors are joint first authors
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Yi-min Li
4Dept 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
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Xiao-qing Liu
4Dept 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
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Ru-chong Chen
1State 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
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Chun-li Tang
1State 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
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Tao Wang
1State 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
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Chun-quan Ou
5State 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
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Li Li
5State 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
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Ping-yan Chen
5State 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
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Ling Sang
4Dept 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
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Wei Wang
2Dept 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
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Jian-fu Li
2Dept 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
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Cai-chen Li
2Dept 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
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Li-min Ou
2Dept 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
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Bo Cheng
2Dept 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
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Shan Xiong
2Dept 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
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Zheng-yi Ni
6Wuhan Jin-yintan Hospital, Wuhan, China
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Jie Xiang
6Wuhan Jin-yintan Hospital, Wuhan, China
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Yu Hu
7Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lei Liu
8Shenzhen Third People's Hospital, Shenzhen, China
9The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, China
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Hong Shan
10The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
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Chun-liang Lei
11Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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Yi-xiang Peng
12The Central Hospital of Wuhan, Wuhan, China
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Li Wei
13Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China
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Yong Liu
14Chengdu Public Health Clinical Medical Center, Chengdu, China
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Ya-hua Hu
15Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
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Peng Peng
16Wuhan Pulmonary Hospital, Wuhan, China
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Jian-ming Wang
17Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
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Ji-yang Liu
18The First Hospital of Changsha, Changsha, China
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Zhong Chen
19The Third People's Hospital of Hainan Province, Sanya, China
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Gang Li
20Huanggang Central Hospital, Huanggang, China
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Zhi-jian Zheng
21Wenling First People's Hospital, Wenling, China
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Shao-qin Qiu
22The Third People's Hospital of Yichang, Yichang, China
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Jie Luo
23Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, China
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Chang-jiang Ye
24Xiantao First People's Hospital, Xiantao, China
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Shao-yong Zhu
25The People's Hospital of Huangpi District, Wuhan, China
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Lin-ling Cheng
1State 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
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Feng Ye
1State 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
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Shi-yue Li
1State 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
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Jin-ping Zheng
1State 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
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Nuo-fu Zhang
1State 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
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Nan-shan Zhong
1State 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
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Jian-xing He
2Dept 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
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  • For correspondence: drjianxing.he@gmail.com nanshan@vip.163.com
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  • FIGURE 1
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    FIGURE 1

    a) The time-dependent risk of reaching the composite end-points between patients with or without any comorbidity. b) The time-dependent risk of reaching the composite end-points between patients without any comorbidity, patients with a single comorbidity and patients with two or more comorbidities. Cox proportional hazard regression models were applied to determine the potential risk factors associated with the composite end-points, with the hazard ratio and 95% confidence interval being reported.

  • FIGURE 2
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    FIGURE 2

    Predictors of the composite end-points in the proportional hazards model. Hazard ratio (95% confidence interval) are shown for the risk factors associated with the composite end-points (admission to intensive care unit, invasive ventilation or death). The comorbidities were classified according to the organ systems as well as the number. The scale bar indicates the hazard ratio. Cox proportional hazard regression models were applied to determine the potential risk factors associated with the composite end-points, with the hazard ratio (95% confidence interval) being reported. The model has been adjusted with age and smoking status.

Tables

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  • Supplementary Materials
  • TABLE 1

    Demographics and clinical characteristics of patients with or without any comorbidities

    VariablesAny comorbidity
    TotalNoYes
    Subjects n15901191399
    Age years48.9±16.344.8±15.260.8±13.4
    Incubation period day3.6±4.23.7±4.33.5±3.9
    Temperature on admission °C37.4±0.937.4±0.937.3±0.9
    Respiratory rate on admission breath·min−121.2±12.021.2±13.721.3±4.7
    Heart rate on admission beat·min−188.7±14.688.5±14.789.2±14.4
    Systolic pressure on admission mmHg126.1±16.4123.5±15.2133.2±17.5
    Diastolic pressure on admission mmHg79.5±25.679±28.980.9±12.6
    Highest temperature °C38.3±1.638.3±1.138.2±2.6
    Sex
     Male904/1578 (57.3)667/1182 (56.4)237/396 (59.8)
     Female674/1578 (42.7)515/1182 (43.6)159/396 (40.2)
    Smoking status
     Never/unknown1479/1590 (93)1127/1191 (94.6)352/399 (88.2)
     Former/current111/1590 (7)64/1191 (5.4)47/399 (11.8)
    Symptoms
     Fever1351/1536 (88)1002/1148 (87.3)349/388 (89.9)
     Conjunctival congestion10/1345 (0.7)7/1014 (0.7)3/331 (0.9)
     Nasal congestion73/1299 (5.6)59/979 (6)14/320 (4.4)
     Headache205/1328 (15.4)151/1002 (15.1)54/326 (16.6)
     Dry cough1052/1498 (70.2)775/1116 (69.4)277/382 (72.5)
     Pharyngodynia194/1317 (14.7)148/999 (14.8)46/318 (14.5)
     Productive cough513/1424 (36)363/1064 (34.1)150/360 (41.7)
     Fatigue584/1365 (42.8)435/1031 (42.2)149/334 (44.6)
     Haemoptysis16/1315 (1.2)9/991 (0.9)7/324 (2.2)
     Shortness of breath331/1394 (23.7)185/1041 (17.8)146/353 (41.4)
     Nausea/vomiting80/1371 (5.8)44/1025 (4.3)36/346 (10.4)
     Diarrhoea57/1359 (4.2)39/1023 (3.8)18/336 (5.4)
     Myalgia/arthralgia234/1338 (17.5)174/1007 (17.3)60/331 (18.1)
     Chill163/1333 (12.2)129/1006 (12.8)34/327 (10.4)
    Signs
     Throat congestion21/1286 (1.6)16/973 (1.6)5/313 (1.6)
     Tonsil swelling31/1376 (2.3)22/1024 (2.1)9/352 (2.6)
     Enlargement of lymph nodes2/1375 (0.1)1/1027 (0.1)1/348 (0.3)
     Rash3/1378 (0.2)2/1032 (0.2)1/346 (0.3)
     Unconsciousness20/1421 (1.4)11/1063 (1)9/358 (2.5)
    Abnormal chest image
     Radiograph243/1590 (15.3)236/1566 (15.1)44036 (29.2)
     Computed tomography1130/1590 (71.1)1113/1566 (71.1)17/24 (70.8)
    Hubei
     Yes647/1590 (40.7)434/1191 (36.4)213/399 (53.4)
     No943/1590 (59.3)757/1191 (63.6)186/399 (46.6)
    Wuhan contacted
     Yes1334/1590 (83.9)983/1191 (82.5)351/399 (88)
     No256/1590 (16.1)208/1191 (17.5)48/399 (12)
    Severity254/1590 (16)123/1191 (10.3)131/399 (32.8)
    Composite end-point131/1590 (8.2)54/1191 (4.5)77/399 (19.3)
    Death50/1590 (3.1)15/1191 (1.3)35/399 (8.8)
    Admission to ICU99/1590 (6.2)45/1191 (3.8)54/399 (13.5)
    Invasive ventilation50/1590 (3.1)19/1191 (1.6)31/399 (1.6)

    Data are presented as mean±sd or n/N (%), where N is the total number of patients with available data. ICU: intensive care unit.

    • TABLE 2

      Demographics and clinical characteristics of patients with 1 or ≥2 comorbidities

      Variables1 comorbidity≥2 comorbidities
      Subjects n269130
      Age years58.2±13.166.2±12.2
      Incubation period days3.2±3.14.0±5.2
      Temperature on admission °C37.4±0.937.1±0.9
      Respiratory rate on admission breath·min−121.4±4.621.2±5
      Heart rate beat·min−190.2±14.687.2±13.7
      Systolic pressure on admission mmHg132.2±16.5135.3±19.4
      Diastolic pressure on admission mmHg81.7±12.579.5±12.9
      Highest temperature °C38.2±3.038.4±0.8
      Sex
       Male158/268 (59.0)79/128 (61.7)
       Female110/268 (41.0)49/128 (38.3)
      Smoking status
       Never/unknown234/269 (87.0)118/130 (90.8)
       Former/current35/269 (13.0)12/130 (9.2)
      Symptoms
       Fever241/263 (91.6)108/125 (86.4)
       Conjunctival congestion3/222 (1.4)0/109 (0)
       Nasal congestion5/213 (2.3)9/107 (8.4)
       Headache34/220 (15.5)20/106 (18.9)
       Dry cough195/258 (75.6)82/124 (66.1)
       Pharyngodynia33/218 (15.1)13/100 (13.0)
       Productive cough101/241 (41.9)49/119 (41.2)
       Fatigue97/227 (42.7)52/107 (48.6)
       Haemoptysis4/219 (1.8)3/105 (2.9)
       Shortness of breath79/232 (34.1)67/121 (55.4)
       Nausea/vomiting23/236 (9.7)13/110 (11.8)
       Diarrhoea11/229 (4.8)7/107 (6.5)
       Myalgia/arthralgia45/227 (19.8)15/104 (14.4)
       Chill25/222 (11.3)9/105 (8.6)
      Signs
       Throat congestion4/216 (1.9)1/97 (1)
       Tonsil swelling5/234 (2.1)4/118 (3.4)
       Enlargement of lymph nodes1/232 (0.4)0/116 (0)
       Rash0/231 (0)1/115 (0.9)
       Unconsciousness3/240 (1.3)6/118 (5.1)
      Abnormal chest image
       Radiograph63/269 (23.4)27/130 (20.8)
       Computed tomography200/269 (74.3)96/130 (73.8)
      Hubei
       Yes120/269 (44.6)93/130 (71.5)
       No149/269 (55.4)37/130 (28.5)
      Wuhan contacted
       Yes229/269 (85.1)122/130 (93.8)
       No40/269 (14.9)8/130 (6.2)
      Severity79/269 (29.4)52/130 (40.0)
      Composite end-point40/269 (14.9)37/130 (28.5)
      Deaths15/269 (5.6)20/130 (15.4)
      Admission to ICU31/269 (11.5)23/130 (17.7)
      Invasive ventilation17/269 (6.3)14/130 (10.8)

      Data are mean±sd, n/N (%), where N is the total number of patients with available data. ICU: intensive care unit.

      • TABLE 3

        Demographics and clinical characteristics of patients stratified by different comorbidities

        COPDDiabetesHypertensionCardiovascular diseaseCerebrovascular disease
        NoYesNoYesNoYesNoYesNoYes
        Subjects n15662414601301321269153159156030
        Age years48.5±16.074.7±6.847.8±16.161.2±13.446.2±15.662.1±12.548.2±15.966.3±15.148.5±16.170.4±8.9
        Incubation period day3.6±4.24.5±3.23.6±4.13.8±5.03.6±4.23.6±4.13.7±4.23.3±3.73.6±4.23.8±3.4
        Temperature on admission °C37.4±0.937.3±0.937.4±0.937.2±1.037.4±0.937.2±0.937.4±0.937.3±137.4±0.936.9±0.8
        Respiratory rate on admission breath·min−121.2±12.121.8±5.221.2±12.421.4±5.421.2±13.121.3±4.521.2±12.221.4±6.221.3±12.119.9±3.3
        Heart rate beat·min−188.6±14.690.2±12.888.6±14.689.1±14.388.6±14.789±14.388.8±14.686.4±14.988.8±14.684.5±11.4
        Systolic pressure on admission mmHg126±16.4131±17.5125.3±15.9134.4±19.1123.9±15.2135.4±18.2125.8±16.3132.3±18.8125.9±16.4132.9±16
        Diastolic pressure on admission mmHg79.6±25.777±11.979.4±26.480.9±13.279.2±27.781±12.579.6±25.978.4±13.679.6±25.877.4±9.6
        Highest temperature °C38.3±1.638.5±0.638.3±1.738.4±0.838.3±1.338.2±2.738.3±1.738.5±0.838.3±1.638.2±1
        Sex
         Male884/1554 (56.9)20/24 (83.3)828/1449 (57.1)76/129 (58.9)748/1312 (57)156/266 (58.6)868/1520 (57.1)36/58 (62.1)881/1548 (56.9)23/30 (76.7)
         Female670/1554 (43.1)4/24 (16.7)621/1449 (42.9)53/129 (41.1)564/1312 (43)110/266 (41.4)652/1520 (42.9)22/58 (37.9)667/1548 (43.1)7/30 (23.3)
        Smoking status
         Never/unknown1458/1566 (93.1)21/24 (87.5)1368/1460 (93.7)111/130 (85.4)1232/1321 (93.3)247/269 (91.8)1426/1531 (93.1)53/59 (89.8)1453/1560 (93.1)26/30 (86.7)
         Former/current108/1566 (6.9)3/24 (12.5)92/1460 (6.3)19/130 (14.6)89/1321 (6.7)22/269 (8.2)105/1531 (6.9)6/59 (10.2)107/1560 (6.9)4/30 (13.3)
        Symptoms
         Fever1331/1513 (88)20/23 (87.0)1239/1412 (87.7)112/124 (90.3)1113/1273 (87.4)238/263 (90.5)1308/1482 (88.3)43/54 (79.6)1328/1507 (88.1)23/29 (79.3)
         Conjunctival  congestion10/1325 (0.8)0/20 (0)9/1237 (0.7)1/108 (0.9)9/1120 (0.8)1/225 (0.4)10/1299 (0.8)0/46 (0)10/1320 (0.8)0/25 (0)
         Nasal congestion72/1281 (5.6)1/18 (5.6)66/1195 (5.5)7/104 (6.7)62/1079 (5.7)11/220 (5)67/1253 (5.3)6/46 (13.0)73/1275 (5.7)0/24 (0)
         Headache202/1309 (15.4)3/19 (15.8)187/1225 (15.3)18/103 (17.5)166/1106 (15)39/222 (17.6)197/1283 (15.4)8/45 (17.8)197/1303 (15.1)8/25 (32.0)
         Dry cough1038/1474 (70.4)14/24 (58.3)972/1378 (70.5)80/120 (66.7)854/1238 (69)198/260 (76.2)1018/1442 (70.6)34/56 (60.7)1035/1469 (70.5)17/29 (58.6)
         Pharyngodynia189/1300 (14.5)5/17 (29.4)182/1219 (14.9)12/98 (12.2)165/1102 (15)29/215 (13.5)185/1272 (14.5)9/45 (20)192/1296 (14.8)2/21 (9.5)
         Productive cough502/1400 (35.9)11/24 (45.8)462/1309 (35.3)51/115 (44.3)403/1178 (34.2)110/246 (44.7)499/1373 (36.3)14/51 (27.5)504/1397 (36.1)9/27 (33.3)
         Fatigue573/1347 (42.5)11/18 (61.1)529/1257 (42.1)55/108 (50.9)488/1143 (42.7)96/222 (43.2)564/1318 (42.8)20/47 (42.6)574/1344 (42.7)10/21 (47.6)
         Haemoptysis15/1296 (1.2)1/19 (5.3)12/1214 (1.0)4/101 (4.0)12/1096 (1.1)4/219 (1.8)15/1268 (1.2)1/47 (2.1)16/1292 (1.2)0/23 (0)
         Shortness of  breath316/1371 (23)15/23 (65.2)277/1279 (21.7)54/115 (47.0)223/1154 (19.3)108/240 (45)310/1342 (23.1)21/52 (40.4)319/1366 (23.4)12/28 (42.9)
         Nausea/vomiting77/1350 (5.7)3/21 (14.3)69/1264 (5.5)11/107 (10.3)55/1134 (4.9)25/237 (10.5)73/1321 (5.5)7/50 (14.0)79/1348 (5.9)1/23 (4.3)
         Diarrhoea57/1338 (4.3)0/21 (0)48/1255 (3.8)9/104 (8.7)46/1129 (4.1)11/230 (4.8)53/1313 (4.0)4/46 (8.7)57/1336 (4.3)0/23 (0)
         Myalgia/arthralgia231/1320 (17.5)3/18 (16.7)218/1234 (17.7)16/104 (15.4)188/1112 (16.9)46/226 (20.4)227/1294 (17.5)7/44 (15.9)233/1317 (17.7)1/21 (4.8)
         Chill159/1313 (12.1)4/20 (20.0)151/1230 (12.3)12/103 (11.7)140/1111 (12.6)23/222 (10.4)161/1290 (12.5)2/43 (4.7)162/1310 (12.4)1/23 (4.3)
        Signs
         Throat  congestion21/1269 (1.7)0/17 (0)20/1189 (1.7)1/97 (1)18/1075 (1.7)3/211 (1.4)21/1245 (1.7)0/41 (0)21/1266 (1.7)0/20 (0)
         Tonsil swelling31/1355 (2.3)0/21 (0)28/1265 (2.2)3/111 (2.7)25/1133 (2.2)6/243 (2.5)29/1326 (2.2)2/50 (4.0)31/1348 (2.3)0/28 (0)
         Enlargement of  lymph nodes2/1355 (0.1)0/20 (0)2/1267 (0.2)0/108 (0)2/1135 (0.2)0/240 (0)1/1325 (0.1)1/50 (2.0)2/1347 (0.1)0/28 (0)
         Rash3/1357 (0.2)0/21 (0)2/1270 (0.2)1/108 (0.9)2/1141 (0.2)1/237 (0.4)3/1327 (0.2)0/51 (0)3/1351 (0.2)0/27 (0)
         Unconsciousness18/1400 (1.3)2/21 (9.5)18/1309 (1.4)2/112 (1.8)12/1175 (1.0)8/246 (3.3)17/1371 (1.2)3/50 (6)19/1392 (1.4)1/29 (3.4)
        Abnormal chest image
         Radiograph236/1566 (15.1)7/24 (29.2)218/1460 (14.9)25/130 (19.2)178/1321 (13.5)65/269 (24.2)231/1531 (15.1)12/59 (20.3)231/1560 (14.8)12/30 (40)
         Computed  tomography1113/1566 (71.1)17/24 (70.8)1034/1460 (70.8)96/130 (73.8)926/1321 (70.1)204/269 (75.8)1090/1531 (71.2)40/59 (67.8)1111/1560 (71.2)19/30 (63.3)
        Hubei
         Yes633/1566 (40.4)14/24 (58.3)568/1460 (38.9)79/130 (60.8)491/1321 (37.2)156/269 (58)609/1531 (39.8)38/59 (64.4)623/1560 (39.9)24/30 (80.0)
         No933/1566 (59.6)10/24 (41.7)892/1460 (61.1)51/130 (39.2)830/1321 (62.8)113/269 (42)922/1531 (60.2)21/59 (35.6)937/1560 (60.1)6/30 (20.0)
        Wuhan contacted
         Yes1312/1566 (83.8)22/24 (91.7)1216/1460 (83.3)118/130 (90.8)1092/1321 (82.7)242/269 (90)1282/1531 (83.7)52/59 (88.1)1306/1560 (83.7)28/30 (93.3)
         No254/1566 (16.2)2/24 (8.3)244/1460 (16.7)12/130 (9.2)229/1321 (17.3)27/269 (10)249/1531 (16.3)7/59 (11.9)254/1560 (16.3)2/30 (6.7)
        Severity239/1566 (15.3)15/24 (62.5)209/1460 (14.3)45/130 (34.6)166/1321 (12.6)88/269 (32.7)234/1531 (15.3)20/59 (33.9)239/1560 (15.3)15/30 (50)
        Composite end-point119/1566 (7.6)12/24 (50.0)100/1460 (6.8)31/130 (23.8)78/1321 (5.9)53/269 (19.7)118/1531 (7.7)13/59 (22.0)121/1560 (7.8)10/30 (33.3)
        Deaths44/1566 (2.8)6/24 (25.0)37/1460 (2.5)13/130 (10.0)22/1321 (1.7)28/269 (10.4)42/1531 (2.7)8/59 (13.6)44/1560 (2.8)6/30 (20)
        Admission to ICU92/1566 (5.9)7/24 (29.2)80/1460 (5.5)19/130 (14.6)61/1321 (4.6)38/269 (14.1)91/1531 (5.9)8/59 (13.6)92/1560 (5.9)7/30 (23.3)
        Invasive ventilation45/1566 (2.9)5/24 (20.8)39/1460 (2.7)11/130 (8.5)28/1321 (2.1)22/269 (8.2)44/1531 (2.9)6/59 (10.2)46/1560 (2.9)4/30 (13.3)
        Hepatitis B infectionMalignancyChronic kidney diseaseImmunodeficiency
        NoYesNoYesNoYesNoYes
        Subjects n15622815721815692115873
        Age years48.9±16.350.8±14.848.7±16.263.1±12.148.8±16.263.7±1448.9±16.351±21.7
        Incubation period day3.7±4.23±2.83.7±4.23.1±3.13.6±4.13.3±7.53.6±4.112.7±16.3
        Temperature on admission °C37.4±0.937.3±0.837.4±0.937.3±0.937.4±0.937.2±137.4±0.936.6±0.2
        Respiratory rate on admission breath·min−121.2±12.121.2±321.3±12.120.2±1.621.3±12.119±2.821.3±1219±1
        Heart rate beat·min−188.7±14.686.3±13.288.7±14.689.4±13.188.7±14.689.1±12.588.7±14.691±18.5
        Systolic pressure on admission mmHg126.1±16.4124.8±14.7126±16.4128.3±14.5125.9±16.3135.4±20.5126.1±16.4127.3±7.4
        Diastolic pressure on admission mmHg79.6±25.778.3±1379.5±25.781.2±8.879.5±25.779.8±1479.5±25.684.7±15
        Highest temperature °C38.3±1.537.6±4.438.3±1.638.5±0.938.3±1.638.5±0.538.3±1.638±0.5
        Sex
         Male885/1550 (57.1)19/28 (67.9)893/1560 (57.2)11/18 (61.1)891/1559 (57.2)13/19 (68.4)904/1575 (57.4)0/3 (0)
         Female665/1550 (42.9)9/28 (32.1)667/1560 (42.8)7/18 (38.9)668/1559 (42.8)6/19 (31.6)671/1575 (42.6)3/3 (100)
        Smoking status
         Never/unknown1454/1562 (93.1)25/28 (89.3)1465/1572 (93.2)14/18 (77.8)1459/1569 (93)20/21 (95.2)1477/1587 (93.1)2/3 (66.7)
         Former/current108/1562 (6.9)3/28 (10.7)107/1572 (6.8)4/18 (22.2)110/1569 (7)1/21 (4.8)110/1587 (6.9)1/3 (33.3)
        Symptoms
         Fever1326/1508 (87.9)25/28 (89.3)1335/1519 (87.9)16/17 (94.1)1334/1516 (88)17/20 (85)1348/1533 (87.9)3/3 (100)
         Conjunctival  congestion9/1323 (0.7)1/22 (4.5)10/1330 (0.8)0/15 (0)10/1328 (0.8)0/17 (0)10/1343 (0.7)0/2 (0)
         Nasal congestion73/1277 (5.7)0/22 (0)71/1285 (5.5)2/14 (14.3)73/1282 (5.7)0/17 (0)73/1297 (5.6)0/2 (0)
         Headache202/1306 (15.5)3/22 (13.6)203/1314 (15.4)2/14 (14.3)203/1311 (15.5)2/17 (11.8)205/1326 (15.5)0/2 (0)
         Dry cough1037/1472 (70.4)15/26 (57.7)1039/1481 (70.2)13/17 (76.5)1037/1479 (70.1)15/19 (78.9)1050/1495 (70.2)2/3 (66.7)
         Pharyngodynia188/1294 (14.5)6/23 (26.1)193/1303 (14.8)1/14 (7.1)191/1300 (14.7)3/17 (17.6)193/1315 (14.7)1/2 (50)
         Productive cough508/1401 (36.3)5/23 (21.7)504/1408 (35.8)9/16 (56.3)505/1407 (35.9)8/17 (47.1)512/1421 (36)1/3 (33.3)
         Fatigue570/1340 (42.5)14/25 (56)577/1349 (42.8)7/16 (43.8)581/1350 (43)3/15 (20)583/1363 (42.8)1/2 (50)
         Haemoptysis16/1293 (1.2)0/22 (0)15/1299 (1.2)1/16 (6.3)16/1300 (1.2)0/15 (0)16/1313 (1.2)0/2 (0)
         Shortness of  breath321/1370 (23.4)10/24 (41.7)323/1377 (23.5)8/17 (47.1)321/1375 (23.3)10/19 (52.6)330/1392 (23.7)1/2 (50)
         Nausea/vomiting78/1349 (5.8)2/22 (9.1)78/1355 (5.8)2/16 (12.5)79/1351 (5.8)1/20 (5)80/1369 (5.8)0/2 (0)
         Diarrhoea55/1337 (4.1)2/22 (9.1)57/1343 (4.2)0/16 (0)56/1339 (4.2)1/20 (5)56/1356 (4.1)1/3 (33.3)
         Myalgia/arthralgia232/1316 (17.6)2/22 (9.1)231/1322 (17.5)3/16 (18.8)233/1323 (17.6)1/15 (6.7)233/1336 (17.4)1/2 (50)
         Chill161/1310 (12.3)2/23 (8.7)162/1318 (12.3)1/15 (6.7)161/1317 (12.2)2/16 (12.5)163/1331 (12.2)0/2 (0)
        Signs
         Throat congestion21/1264 (1.7)0/22 (0)20/1271 (1.6)1/15 (6.7)21/1271 (1.7)0/15 (0)20/1284 (1.6)1/2 (50)
         Tonsil swelling30/1353 (2.2)1/23 (4.3)30/1359 (2.2)1/17 (5.9)30/1356 (2.2)1/20 (5)31/1373 (2.3)0/3 (0)
         Enlargement of  lymph nodes2/1352 (0.1)0/23 (0)2/1359 (0.1)0/16 (0)2/1355 (0.1)0/20 (0)2/1372 (0.1)0/3 (0)
         Rash3/1355 (0.2)0/23 (0)3/1361 (0.2)0/17 (0)3/1360 (0.2)0/18 (0)3/1376 (0.2)0/2 (0)
         Unconsciousness19/1397 (1.4)1/24 (4.2)20/1404 (1.4)0/17 (0)20/1401 (1.4)0/20 (0)20/1418 (1.4)0/3 (0)
        Abnormal chest image
         Radiograph240/1562 (15.4)3/28 (10.7)239/1572 (15.2)4/18 (22.2)240/1569 (15.3)3/21 (14.3)243/1587 (15.3)0/3 (0)
         Computed  tomography1111/1562 (71.1)19/28 (67.9)1113/1572 (70.8)17/18 (94.4)1116/1569 (71.1)14/21 (66.7)1127/1587 (71)3/3 (100)
        Hubei
         Yes638/1562 (40.8)9/28 (32.1)635/1572 (40.4)12/18 (66.7)631/1569 (40.2)16/21 (76.2)645/1587 (40.6)2/3 (66.7)
         No924/1562 (59.2)19/28 (67.9)937/1572 (59.6)6/18 (33.3)938/1569 (59.8)5/21 (23.8)942/1587 (59.4)1/3 (33.3)
        Wuhan contacted
         Yes1312/1562 (84)22/28 (78.6)1316/1572 (83.7)18/18 (100)1316/1569 (83.9)18/21 (85.7)1331/1587 (83.9)3/3 (100)
         No250/1562 (16)6/28 (21.4)256/1572 (16.3)0/18 (0)253/1569 (16.1)3/21 (14.3)256/1587 (16.1)0/3 (0)
        Severity245/1562 (15.7)9/28 (32.1)245/1572 (15.6)9/18 (50)246/1569 (15.7)8/21 (38.1)253/1587 (15.9)1/3 (33.3)
        Composite end-point128/1562 (8.2)3/28 (10.7)124/1572 (7.9)7/18 (38.9)125/1569 (8)6/21 (28.6)130/1587 (8.2)1/3 (33.3)
        Deaths49/1562 (3.1)1/28 (3.6)47/1572 (3.0)3/18 (16.7)45/1569 (2.9)5/21 (23.8)50/1587 (3.2)0/3 (0)
        Admission to ICU98/1562 (6.3)1/28 (3.6)94/1572 (6.0)5/18 (27.8)98/1569 (6.2)1/21 (4.8)98/1587 (6.2)1/3 (33.3)
        Invasive ventilation48/1562 (3.1)2/28 (7.1)48/1562 (3.1)2/18 (11.1)49/1569 (3.1)1/21 (4.8)50/1587 (3.2)0/3 (0)

        Data are mean±sd, n/N (%), where N is the total number of patients with available data. ICU: intensive care unit.

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        Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis
        Wei-jie Guan, Wen-hua Liang, Yi Zhao, Heng-rui Liang, Zi-sheng Chen, Yi-min Li, Xiao-qing Liu, Ru-chong Chen, Chun-li Tang, Tao Wang, Chun-quan Ou, Li Li, Ping-yan Chen, Ling Sang, Wei Wang, Jian-fu Li, Cai-chen Li, Li-min Ou, Bo Cheng, Shan Xiong, Zheng-yi Ni, Jie Xiang, Yu Hu, Lei Liu, Hong Shan, Chun-liang Lei, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Lin-ling Cheng, Feng Ye, Shi-yue Li, Jin-ping Zheng, Nuo-fu Zhang, Nan-shan Zhong, Jian-xing He
        European Respiratory Journal May 2020, 55 (5) 2000547; DOI: 10.1183/13993003.00547-2020

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        Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis
        Wei-jie Guan, Wen-hua Liang, Yi Zhao, Heng-rui Liang, Zi-sheng Chen, Yi-min Li, Xiao-qing Liu, Ru-chong Chen, Chun-li Tang, Tao Wang, Chun-quan Ou, Li Li, Ping-yan Chen, Ling Sang, Wei Wang, Jian-fu Li, Cai-chen Li, Li-min Ou, Bo Cheng, Shan Xiong, Zheng-yi Ni, Jie Xiang, Yu Hu, Lei Liu, Hong Shan, Chun-liang Lei, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Lin-ling Cheng, Feng Ye, Shi-yue Li, Jin-ping Zheng, Nuo-fu Zhang, Nan-shan Zhong, Jian-xing He
        European Respiratory Journal May 2020, 55 (5) 2000547; DOI: 10.1183/13993003.00547-2020
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