Predictors of severe course of COVID-19 depending on comorbid background

Abstract

PurposeThe COVID-19 pandemic poses a challenge for the medical community to study the peculiarities of patient management, particularly to refine the risk of a severe course of disease, depending on the presence of comorbidities.Aim of study: identification of factors affecting the likelihood of developing a severe course of COVID - 19 in comorbid patients.Methods & MaterialsA retrospective study of hospitalized patients diagnosed with COVID-19 with a comorbid background in the period from January to November 2020 in the Russian Federation. An analysis of the severity of the course was carried out depending on the comorbid background with the calculation of OR and CI 95%, significant factors influencing the development of a severe course of the disease were identified.ResultsOf 67567 patients, 22545 had comorbidities. 7025 (31.2%) of them had severe course of illness, 15520 (68.8%) - mild/moderate. 45,022 patients had no comorbidity: severe course was in 2558 (5.7%) patients, mild/moderate – in 42464 (94.3%). Calculating from the total number of patients: comorbidity and severe course was recorded in 10.4%; comorbidity and mild/moderate course - in 23%; severe course without comorbidity was in 3.8%; mild/moderate course without comorbidity was in 62.8%. The comorbidity increased the risk of developing a severe course by 7.514 times, compared with patients without a comorbid background (95% CI: 7.156-7.890). The presence of comorbidities of the respiratory system was detected in 3042 patients (4.5% of the total) and increased the risk of developing a severe course by 1.618 times (95%, CI: 1.478-1.771); cardiovascular system - 12706 (18.8%), risk increased by 5.015 times (95% CI: 4.788-5.253), endocrine - 2314 (3.4%), risk increased by 3.274 times (95%, CI: 2.995-3.579), oncology - 944 (1.4%), risk increased by 4.072 times (95% CI: 3.567-4.648). These indicators are statistically significant (p <0.001). Diseases of the gastrointestinal tract (p = 0.213) and urinary system (p = 0.12) were statistically insignificant.ConclusionThe results indicate an increasing risk of severe course of COVID-19 in patients with comorbidities.. Additional diagnostic measures to search for a comorbid background will allow medical professionals to make more accurate predictions for each individual patient.