Prevalence and impact of comorbidities in Tunisian moderate to severe COVID-19 patients

Abstract

Comorbid conditions were reported as risk factors for poor prognosis in COVID-19 in many countries. The aim of our study was to relate the prevalence of the most frequent comorbidities in Tunisian moderate to severe COVID-19 patients and to investigate their impacts on the disease’s outcomes. We conducted a retrospective study that included COVID-19 patients admitted in our pulmonology department B of Abderrahmen Mami hospital, in Tunisia, from October 9, 2020 to February 9,2021. We compared the characteristics of patients with underlying comorbidities(n=160) to those without medical history(n=47).Of 207 enrolled patients, median age was 64 years old [22-98] and 133 were men (64%). Patients with at least one comorbidity(77%) were younger (p=0.01)and were more likely to have a smoking history (p=0.04).The most frequent comorbidities reported were : hypertension (46%), diabetes (40%), chronic obstructive pulmonary disease (COPD)(20%), coronary disease (12%), hypothyroidism (5.7%) and malignancy(4.8%). Chronic kidney disease and neurological disease were present in 4.3% of the cases each. Median symptom onset was shorter in patients with at least one comorbidity(7.5days versus 10days). By February 9, 153 patients were discharged (74%).Twelve patients died (5.7%). There was no differences between the two groups in median hospital stay and in mortality. Patients with comorbidities were at higher risk of severe pneumonia (p=0.001), acute kidney injury (p=0.01) and intensive care unit transfer(p=0.05). Cardiovascular disease, diabetes and COPD are the most prevalent conditions found in our study. These comorbidities seem to be associated with greater risk of COVID-19 complications.