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Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis

Wei-Jie GuanGuangzhou Medical UniversityWenhua LiangDept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaYi ZhaoThese authors are joint first authorsHeng-rui LiangThese authors are joint first authorsZi‐Sheng ChenThe Third People's Hospital of Hainan Province, Sanya, ChinaYimin LiDept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaXiao-qing LiuDept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaRu-chong ChenState Key Laboratory of Respiratory DiseaseChun-li TangGuangzhou Medical UniversityTao WangState Key Laboratory of Respiratory DiseaseChun‐Quan OuState Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, ChinaLi LiState Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, ChinaPing-Yan ChenState Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, ChinaLing SangDept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaWei WangState Key Laboratory of Respiratory DiseaseJian-fu LiGuangzhou Medical UniversityCaichen LiDept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaLi-min OuDept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaBo ChengGuangzhou Medical UniversityShan XiongState Key Laboratory of Respiratory DiseaseZheng-yi NiWuhan Jin-yintan Hospital, Wuhan, ChinaJie XiangWuhan Jin-yintan Hospital, Wuhan, ChinaYu HuHuangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, ChinaLei LiuShenzhen Third People's Hospital, Shenzhen, ChinaHong ShanThe Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, ChinaChun-liang LeiGuangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, ChinaYi-xiang PengThe Central Hospital of Wuhan, Wuhan, ChinaLi WeiWuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, ChinaYong LiuChengdu Public Health Clinical Medical Center, Chengdu, ChinaYa-hua HuHuangshi Central HospitalPeng PengWuhan Pulmonary Hospital, Wuhan, ChinaJian Ming WangTianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaJiyang LiuThe First Hospital of Changsha, Changsha, ChinaZhong ChenThese authors are joint first authorsGang LiHuanggang Central Hospital, Huanggang, ChinaZhi-jian ZhengWenling First People's Hospital, Wenling, ChinaShao-qin QiuThe Third People's Hospital of Yichang, Yichang, ChinaJie LuoTaihe HospitalChang-jiang YeShao-yong ZhuLin-ling ChengState Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, ChinaFeng YeState Key Laboratory of Respiratory DiseaseShi-yue LiGuangzhou Medical UniversityJin-ping ZhengGuangzhou Medical UniversityNuo-fu ZhangState Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, ChinaNanshan ZhongState Key Laboratory of Respiratory DiseaseJian-xing HeDept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

2020en

ABI

Annotatsiya

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.

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DOI: 10.1183/13993003.00547-2020

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