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, China Medical Treatment Expert Group for COVID-19, 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, China Medical Treatment Expert Group for COVID-19
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.
Conflict of interest statement
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.
Copyright ©ERS 2020.
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Source: PubMed