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.
Abstract
The presence and number of comorbidities predict clinical outcomes of COVID-19 http://bit.ly/3b9ibw5
Footnotes
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Author contributions: Wei-jie Guan, Wen-hua Liang, Jian-xing He, and Nan-shan Zhong participated in study design and study conception; Wen-hua Liang, Yi Zhao, Heng-rui Liang, Zi-sheng Chen, Chun-quan Ou, L. Li, Ping-yan Chen, Jian-fu Li, Cai-chen Li, Li-min Ou, Bo Cheng, Wei Wang and Shan Xiong performed data analysis; Ru-chong Chen, Chun-li Tang, Tao Wang, Ling Sang, Zheng-yi Ni, Jie Xiang, Yu Hu, L. Li, 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, and Nan-shan Zhong recruited patients; Wei-jie Guan, Jian-xing He, Wen-hua Liang and Nan-shan Zhong drafted the manuscript; all authors provided critical review of the manuscript and approved the final draft for publication.
Support statement: Supported by National Health Commission, Department of Science and Technology of Guangdong Province. The funder had no role in the conduct of the study. Funding information for this article has been deposited with the Crossref Funder Registry.
Conflict of interest: Wei-jie Guan has nothing to disclose.
Conflict of interest: Wen-hua Liang has nothing to disclose.
Conflict of interest: Yi Zhao has nothing to disclose.
Conflict of interest: Heng-rui Liang has nothing to disclose.
Conflict of interest: Zi-sheng Chen has nothing to disclose.
Conflict of interest: Yi-min Li has nothing to disclose.
Conflict of interest: Xiao-qing Liu has nothing to disclose.
Conflict of interest: Ru-chong Chen has nothing to disclose.
Conflict of interest: Chun-li Tang has nothing to disclose.
Conflict of interest: Tao Wang has nothing to disclose.
Conflict of interest: Chun-quan Ou has nothing to disclose.
Conflict of interest: Li has nothing to disclose.
Conflict of interest: Ping-yan Chen has nothing to disclose.
Conflict of interest: Ling Sang has nothing to disclose.
Conflict of interest: Wei Wang has nothing to disclose.
Conflict of interest: Jian-fu Li has nothing to disclose.
Conflict of interest: Cai-chen Li has nothing to disclose.
Conflict of interest: Li-min Ou has nothing to disclose.
Conflict of interest: Bo Cheng has nothing to disclose.
Conflict of interest: Shan Xiong has nothing to disclose.
Conflict of interest: Zheng-yi Ni has nothing to disclose.
Conflict of interest: Jie Xiang has nothing to disclose.
Conflict of interest: Yu Hu has nothing to disclose.
Conflict of interest: Lei Liu has nothing to disclose.
Conflict of interest: Hong Shan has nothing to disclose.
Conflict of interest: Chun-liang Lei has nothing to disclose.
Conflict of interest: Yi-xiang Peng has nothing to disclose.
Conflict of interest: Li Wei has nothing to disclose.
Conflict of interest: Yong Liu has nothing to disclose.
Conflict of interest: Ya-hua Hu has nothing to disclose.
Conflict of interest: Peng has nothing to disclose.
Conflict of interest: Jian-ming Wang has nothing to disclose.
Conflict of interest: Ji-yang Liu has nothing to disclose.
Conflict of interest: Zhong Chen has nothing to disclose.
Conflict of interest: Gang Li has nothing to disclose.
Conflict of interest: Zhi-jian Zheng has nothing to disclose.
Conflict of interest: Shao-qin Qiu has nothing to disclose.
Conflict of interest: Jie Luo has nothing to disclose.
Conflict of interest: Chang-jiang Ye has nothing to disclose.
Conflict of interest: Shao-yong Zhu has nothing to disclose.
Conflict of interest: Lin-ling Cheng has nothing to disclose.
Conflict of interest: Feng Ye has nothing to disclose.
Conflict of interest: Shi-yue Li has nothing to disclose.
Conflict of interest: Jin-ping Zheng has nothing to disclose.
Conflict of interest: Nuo-fu Zhang has nothing to disclose.
Conflict of interest: Nan-shan Zhong reports grants from the National Health Commission and Dept of Science and Technology of Guangdong Province, during the conduct of the study.
Conflict of interest: Jian-xing He has nothing to disclose.
The version of this article originally published in early view format contained some transcription errors in the total subject numbers presented in table 3. This was an issue that arose in compiling the table and the underlying results and conclusions are not affected by the correction.
- Received March 4, 2020.
- Accepted March 13, 2020.
- Copyright ©ERS 2020
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
