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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 China Medical Treatment Expert Group for Covid-19
European Respiratory Journal 2020; DOI: 10.1183/13993003.00547-2020
Wei-jie Guan
1State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
26joint first authors
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Wen-hua Liang
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
26joint first authors
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Yi Zhao
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
26joint first authors
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Heng-rui Liang
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
26joint first authors
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Zi-sheng Chen
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & 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, Guangdong, China
26joint first authors
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Yi-min Li
4Department of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Xiao-qing Liu
4Department of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease & 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 & 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 & 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 & 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, Department 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, Department 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, Department 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
4Department of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Wei Wang
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Jian-fu Li
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Cai-chen Li
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Li-min Ou
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Bo Cheng
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Shan Xiong
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & 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, Hubei, China
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Jie Xiang
6Wuhan Jin-yintan Hospital, Wuhan, Hubei, China
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Yu Hu
7Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 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, Guangdong, China
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Chun-liang Lei
11Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
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Yi-xiang Peng
12The Central Hospital of Wuhan, Wuhan, Hubei, China
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Li Wei
13Wuhan No.1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, Hubei, China
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Yong Liu
14Chengdu Public Health Clinical Medical Center, Chengdu, Sichuan, China
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Ya-hua Hu
15Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, Hubei, China
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Peng Peng
16Wuhan Pulmonary Hospital, Wuhan, Hubei, China
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Jian-ming Wang
17Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
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Ji-yang Liu
18The First Hospital of Changsha, Changsha, Hunan, China
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Zhong Chen
19The Third People's Hospital of Hainan Province, Sanya, Hainan, China
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Gang Li
20Huanggang Central Hospital, Huanggang, Hubei, China
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Zhi-jian Zheng
21Wenling First People's Hospital, Wenling, Zhejiang, China
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Shao-qin Qiu
22The Third People's Hospital of Yichang, Yichang, Hubei, 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 & 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 & 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 & 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 & 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 & 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 & 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
2Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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  • FIGURE 1
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    FIGURE 1

    Comparison of the time-dependent risk of reaching to the composite endpoints. a) The time-dependent risk of reaching to the composite endpoints between patients with (orange curve) or without any comorbidity (dark blue curve). b) The time-dependent risk of reaching to the composite endpoints between patients without any comorbidity (orange curve), patients with a single comorbidity (dark blue curve), and patients with two or more comorbidities (green curve). Cox proportional hazard regression models were applied to determine the potential risk factors associated with the composite endpoints, with the hazards ratio (HR) and 95% confidence interval (95%CI) being reported.

  • FIGURE 2
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    FIGURE 2

    Predictors of the composite endpoints in the proportional hazards model. Shown in the figure are the hazards ratio (HR) and the 95% confidence interval (95%CI) for the risk factors associated with the composite endpoints (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 HR. Cox proportional hazard regression models were applied to determine the potential risk factors associated with the composite endpoints, with the hazards ratio (HR) and 95% confidence interval (95%CI) being reported. The model has been adjusted with age and smoking status.

Tables

  • Figures
  • TABLE 1

    Demographics and clinical characteristics of patients with or without any comorbidities

    VariablesAny comorbidity
    Total (n=1590)No (n=1191)Yes (n=399)
    Age (years)48.9±16.344.8±15.260.8±13.4
    Incubation period (day)3.6±4.23.7±4.33.5±3.9
    Temperature on admission (℃)37.4±0.937.4±0.937.3±0.9
    Respiratory rate on admission (breath·min−1)21.2±12.021.2±13.721.3±4.7
    Heart rate on admission (beat·min−1)88.7±14.688.5±14.789.2±14.4
    Systolic pressure on admission (mmHg)126.1±16.4123.5±15.2133.2±17.5
    Diastolic pressure on admission (mmHg)79.5±25.679±28.980.9±12.6
    Highest temperature (℃)38.3±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)
     Hemoptysis16/1315 (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)
     Diarrhea57/1359 (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)44 036 (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 endpoint131/1590 (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 mean±standard deviation, n/N (%), where N is the total number of patients with available data.

    COPD: chronic obstructive pulmonary disease; ICU: intensive care unit.

    • TABLE 2

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

      Variables1 comorbidity (n=269)≥2 comorbidities (n=130)
      Age (years)58.2±13.166.2±12.2
      Incubation period (days)3.2±3.14.0±5.2
      Temperature on admission (℃)37.4±0.937.1±0.9
      Respiratory rate on admission (breath·min−1)21.4±4.621.2±5
      Heart rate (bit·minute−1)90.2±14.687.2±13.7
      Systolic pressure on admission (mmHg)132.2±16.5135.3±19.4
      Diastolic pressure on admission (mmHg)81.7±12.579.5±12.9
      Highest temperature (℃)38.2±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)
       Hemoptysis4/219 (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)
       Diarrhea11/229 (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 endpoint40/269 (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±standard deviation, n/N (%), where N is the total number of patients with available data.

      COPD: chronic obstructive pulmonary disease; ICU: intensive care unit.

      • TABLE 3

        Demographics and clinical characteristics of patients stratified by different comorbidities

        COPDDiabetesHypertensionCardiovascular diseaseCerebrovascular disease
        No (n=1566)Yes (n=24)No (n=1460)Yes (n=130)No (n=1321)Yes (n=269)No (n=1531)Yes (n=59)No (n=1560)Yes (n=30)
        Age (year)48.5±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 (day)3.6±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 (℃)37.4±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−1)21.2±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 (bit·minute−1)88.6±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 (mmHg)126±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 (mmHg)79.6±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 (℃)38.3±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)
         Hemoptysis15/1296 (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)
         Diarrhea57/1338 (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 endpoint119/1566 (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
        No (n=1566)Yes (n=24)No (n=1460)Yes (n=130)No (n=1321)Yes (n=269)No (n=1531)Yes (n=59)
        Age (year)48.9±16.350.8±14.848.7±16.263.1±12.148.8±16.263.7±1448.9±16.351±21.7
        Incubation period (day)3.7±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 (℃)37.4±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−1)21.2±12.121.2±321.3±12.120.2±1.621.3±12.119±2.821.3±1219±1
        Heart rate (bit·minute−1)88.7±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 (mmHg)126.1±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 (mmHg)79.6±25.778.3±1379.5±25.781.2±8.879.5±25.779.8±1479.5±25.684.7±15
        Highest temperature (℃)38.3±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)
         Hemoptysis16/1293 (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)
         Diarrhea55/1337 (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 endpoint128/1562 (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±standard deviation, n/N (%), where N is the total number of patients with available data.

        COPD: chronic obstructive pulmonary disease; 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 Jan 2020, 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 Jan 2020, 2000547; DOI: 10.1183/13993003.00547-2020
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