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 coronavirus disease 2019 (Covid-19) by stratifying the comorbidity status.
Methods We analysed the data from 1590 laboratory-confirmed hospitalised patients 575 hospitals in 31 province/autonomous regions/provincial municipalities across mainland China between December 11th, 2019 and January 31st, 2020. We analyse the composite endpoints, which consisted of admission to intensive care unit, or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared according to the presence and number of comorbidities.
Results The mean age was 48.9 years. 686 patients (42.7%) were females. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 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 [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424–5.048], diabetes (HR 1.59, 95%CI 1.03–2.45), hypertension (HR 1.58, 95%CI 1.07–2.32) and malignancy (HR 3.50, 95%CI 1.60–7.64) were risk factors of reaching to the composite endpoints. The HR was 1.79 (95%CI 1.16–2.77) among patients with at least one comorbidity and 2.59 (95%CI 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 predicted clinical outcomes of Covid-19.
Footnotes
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Ethics approval: This study is approved by the ethics committee of the First Affiliated Hospital of Guangzhou Medical University.
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. National Health Commission; Guangdong Science and Technology Department; DOI: http://dx.doi.org/10.13039/501100007162.
Author's contributions: W. J. G., W. H. L., J. X. H., and N. S. Z. participated in study design and study conception; W. H. L., Y. Z., H. R. L., Z. S. C., C. Q. O., L. L., P. Y. C., J. F. L., C. C. L., L. M. O., B. C., W. W. and S. X. performed data analysis; R. C. C., C. L. T., T. W., L. S., Z. Y. N., J. X., Y. H., L. L., H. S., C. L. L., Y. X. P., L. W., Y. L., Y. H. H., P. P., J. M. W., J. Y. L., Z. C., G. L., Z. J. Z., S. Q. Q., J. L., C. J. Y., S. Y. Z., L. L. C., F. Y., S. Y. L., J. P. Z., N. F. Z., and N. S. Z. recruited patients; W. J. G., J. X. H., W. H. L., and N. S. Z. drafted the manuscript; all authors provided critical review of the manuscript and approved the final draft for publication.
Conflict of interest: Dr. Guan has nothing to disclose.
Conflict of interest: Dr. Liang has nothing to disclose.
Conflict of interest: Dr. Zhao has nothing to disclose.
Conflict of interest: Dr. Liang has nothing to disclose.
Conflict of interest: Dr. Chen has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Liu has nothing to disclose.
Conflict of interest: Dr. Chen has nothing to disclose.
Conflict of interest: Dr. Tang has nothing to disclose.
Conflict of interest: Dr. Wang has nothing to disclose.
Conflict of interest: Dr. Ou has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Chen has nothing to disclose.
Conflict of interest: Dr. Sang has nothing to disclose.
Conflict of interest: Dr. Wang has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Ou has nothing to disclose.
Conflict of interest: Dr. Cheng has nothing to disclose.
Conflict of interest: Dr. Xiong has nothing to disclose.
Conflict of interest: Dr. Ni has nothing to disclose.
Conflict of interest: Dr. Xiang has nothing to disclose.
Conflict of interest: Dr. Hu has nothing to disclose.
Conflict of interest: Dr. Liu has nothing to disclose.
Conflict of interest: Dr. Shan has nothing to disclose.
Conflict of interest: Dr. Lei has nothing to disclose.
Conflict of interest: Dr. Peng has nothing to disclose.
Conflict of interest: Dr. Wei has nothing to disclose.
Conflict of interest: Dr. Liu has nothing to disclose.
Conflict of interest: Dr. Hu has nothing to disclose.
Conflict of interest: Dr. Peng has nothing to disclose.
Conflict of interest: Dr. Wang has nothing to disclose.
Conflict of interest: Dr. Liu has nothing to disclose.
Conflict of interest: Dr. Chen has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Zheng has nothing to disclose.
Conflict of interest: Dr. Qiu has nothing to disclose.
Conflict of interest: Dr. Luo has nothing to disclose.
Conflict of interest: Dr. Ye has nothing to disclose.
Conflict of interest: Dr. Zhu has nothing to disclose.
Conflict of interest: Dr. Cheng has nothing to disclose.
Conflict of interest: Dr. Ye has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Zheng has nothing to disclose.
Conflict of interest: Dr. Zhang has nothing to disclose.
Conflict of interest: Dr. Zhong reports grants from National Health Commission, grants from Department of Science and Technology of Guangdong Province, during the conduct of the study.
Conflict of interest: Dr. He has nothing to disclose.
- Received March 4, 2020.
- Accepted March 13, 2020.
- Copyright ©ERS 2020
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