Not Only High Number and Specific Comorbidities but Also Age Are Closely Related to Progression and Poor Prognosis in Patients With COVID-19.

Renqing Zhang,Dafeng Liu,Lang Bai,Dongmei Wang,Yongli Zheng,Yi Mao,Hong Tang,Guifang Zha,Jun Kang

doi:10.3389/fmed.2021.736109

Abstract

Background: Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim: We aimed to investigate the characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods: A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results: Approximately 91.23% (655/718) of COVID-19 patients were younger than 60 years old. Approximately 64.76% (465/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia, and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients. According to spearman correlation analysis the number of comorbidities was correlated positively with disease severity, the number of comorbidities and NAFLD were correlated positively with virus negative conversion time, hypertension, CKD and CVD were primarily associated with those who died, and the above-mentioned correlation existed independently of age. Risk factors included age, the number of comorbidities and hyperlipidaemia for disease severity, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities and age played a predictive role in disease progression and outcomes.Conclusion: Not only high number and specific comorbidities but also age are closely related to progression and poor prognosis in patients with COVID-19. These findings provide a reference for clinicians to focus on not only the number and specific comorbidities but also age in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563.

Highlights

The worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, namely, coronavirus disease 2019 (COVID-19) presents a paramount and urgent threat to global health. [1,2,3,4,5] As of May 11, 2021, there were approximately 157,362,408 confirmed cases, including 3,277,834 deaths, reported worldwide [6]
Except for the chronic kidney disease (CKD) subgroup and the cancer subgroup, the differences were statistically significant. In this COVID-19 cohort, the order of clinical type according to the number of cases was as follows: common, asymptomatic infection, light, critical illness and severe
Three or more comorbidities, and some specific comorbidities, such as hypertension, CKD and cardiovascular disease (CVD), and age are related to progression and death in hospitalized COVID-19 patients

Summary

Introduction

The worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, namely, coronavirus disease 2019 (COVID-19) presents a paramount and urgent threat to global health. [1,2,3,4,5] As of May 11, 2021, there were approximately 157,362,408 confirmed cases, including 3,277,834 deaths, reported worldwide [6]. The overall prognosis of COVID-19 is good, [1,2,3,4,5] some patients with comorbidities or rapid disease progression have a poor outcome [7,8,9,10,11,12]. Previous studies have shown that approximately 66.67∼70.70% of COVID-19 patients have comorbidities; common comorbidities are hypertension, cardiovascular disease (CVD), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), malignancy, chronic kidney disease (CKD), and obesity [13,14,15]. DM and hypertension, or CVD are common underlying diseases related to death in hospitalized cases [14]. Some patients with comorbidities and rapid disease progression have a poor prognosis

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