tetano
Editor, Senior Moderator
Eur Respir J. 2020 Mar 26. pii: 2000547. doi: 10.1183/13993003.00547-2020. [Epub ahead of print]
Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis.
Guan WJ[SUP]1,[/SUP][SUP]2[/SUP], Liang WH[SUP]3,[/SUP][SUP]2[/SUP], Zhao Y[SUP]3,[/SUP][SUP]2[/SUP], Liang HR[SUP]3,[/SUP][SUP]2[/SUP], Chen ZS[SUP]3,[/SUP][SUP]4,[/SUP][SUP]2[/SUP], Li YM[SUP]5[/SUP], Liu XQ[SUP]5[/SUP], Chen RC[SUP]1[/SUP], Tang CL[SUP]1[/SUP], Wang T[SUP]1[/SUP], Ou CQ[SUP]6[/SUP], Li L[SUP]6[/SUP], Chen PY[SUP]6[/SUP], Sang L[SUP]5[/SUP], Wang W[SUP]3[/SUP], Li JF[SUP]3[/SUP], Li CC[SUP]3[/SUP], Ou LM[SUP]3[/SUP], Cheng B[SUP]3[/SUP], Xiong S[SUP]3[/SUP], Ni ZY[SUP]7[/SUP], Xiang J[SUP]7[/SUP], Hu Y[SUP]8[/SUP], Liu L[SUP]9,[/SUP][SUP]10[/SUP], Shan H[SUP]11[/SUP], Lei CL[SUP]12[/SUP], Peng YX[SUP]13[/SUP], Wei L[SUP]14[/SUP], Liu Y[SUP]15[/SUP], Hu YH[SUP]16[/SUP], Peng P[SUP]17[/SUP], Wang JM[SUP]18[/SUP], Liu JY[SUP]19[/SUP], Chen Z[SUP]20[/SUP], Li G[SUP]21[/SUP], Zheng ZJ[SUP]22[/SUP], Qiu SQ[SUP]23[/SUP], Luo J[SUP]24[/SUP], Ye CJ[SUP]25[/SUP], Zhu SY[SUP]26[/SUP], Cheng LL[SUP]1[/SUP], Ye F[SUP]1[/SUP], Li SY[SUP]1[/SUP], Zheng JP[SUP]1[/SUP], Zhang NF[SUP]1[/SUP], Zhong NS[SUP]1[/SUP], He JX[SUP]3[/SUP]; China Medical Treatment Expert Group for Covid-19.
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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 11[SUP]th[/SUP], 2019 and January 31[SUP]st[/SUP], 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.
Copyright ?ERS 2020.
PMID:32217650DOI:10.1183/13993003.00547-2020
Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis.
Guan WJ[SUP]1,[/SUP][SUP]2[/SUP], Liang WH[SUP]3,[/SUP][SUP]2[/SUP], Zhao Y[SUP]3,[/SUP][SUP]2[/SUP], Liang HR[SUP]3,[/SUP][SUP]2[/SUP], Chen ZS[SUP]3,[/SUP][SUP]4,[/SUP][SUP]2[/SUP], Li YM[SUP]5[/SUP], Liu XQ[SUP]5[/SUP], Chen RC[SUP]1[/SUP], Tang CL[SUP]1[/SUP], Wang T[SUP]1[/SUP], Ou CQ[SUP]6[/SUP], Li L[SUP]6[/SUP], Chen PY[SUP]6[/SUP], Sang L[SUP]5[/SUP], Wang W[SUP]3[/SUP], Li JF[SUP]3[/SUP], Li CC[SUP]3[/SUP], Ou LM[SUP]3[/SUP], Cheng B[SUP]3[/SUP], Xiong S[SUP]3[/SUP], Ni ZY[SUP]7[/SUP], Xiang J[SUP]7[/SUP], Hu Y[SUP]8[/SUP], Liu L[SUP]9,[/SUP][SUP]10[/SUP], Shan H[SUP]11[/SUP], Lei CL[SUP]12[/SUP], Peng YX[SUP]13[/SUP], Wei L[SUP]14[/SUP], Liu Y[SUP]15[/SUP], Hu YH[SUP]16[/SUP], Peng P[SUP]17[/SUP], Wang JM[SUP]18[/SUP], Liu JY[SUP]19[/SUP], Chen Z[SUP]20[/SUP], Li G[SUP]21[/SUP], Zheng ZJ[SUP]22[/SUP], Qiu SQ[SUP]23[/SUP], Luo J[SUP]24[/SUP], Ye CJ[SUP]25[/SUP], Zhu SY[SUP]26[/SUP], Cheng LL[SUP]1[/SUP], Ye F[SUP]1[/SUP], Li SY[SUP]1[/SUP], Zheng JP[SUP]1[/SUP], Zhang NF[SUP]1[/SUP], Zhong NS[SUP]1[/SUP], He JX[SUP]3[/SUP]; China Medical Treatment Expert Group for Covid-19.
Author information
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 11[SUP]th[/SUP], 2019 and January 31[SUP]st[/SUP], 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.
Copyright ?ERS 2020.
PMID:32217650DOI:10.1183/13993003.00547-2020