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

European Respiratory Journal - Tập 55 Số 5 - Trang 2000547 - 2020
Guan Wei1,2, Wenhua Liang3,2, Yi Zhao3,2, Heng-rui Liang3,2, Zi‐Sheng Chen3,4,2, Yi Min Li5, Xiaoqing Liu5, Ru-chong Chen1, Chun-li Tang1, Tao Wang1, Chun‐Quan Ou6, Li Li6, Ping Yan Chen6, Ling Sang5, Wei Wang3, Jian-fu Li3, Caichen Li3, Li-min Ou3, Bo Cheng3, Shan Xiong3, Zheng-yi Ni7, Jie Xiang7, Yu Hu8, Lei Liu9,10, Hong Shan11, Chun-liang Lei12, Yi-xiang Peng13, Li Wei14, Yong Liu15, Ya Hu16, Peng Peng17, Jian Ming Wang18, Jiyang Liu19, Zhong Chen20, Gang Li21, Zhi Zheng22, Shao-qin Qiu23, Jie Luo24, Chang-jiang Ye25, Shao Zhu26, Lin-ling Cheng1, Feng Ye1, Shi-yue Li1, Jintao Zheng1, Nuo-fu Zhang1, Nan-shan Zhong1, Jian-xing He3
1State 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, China
2These authors are joint first authors
3Dept 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
4The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China
5Dept 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, China
6State 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, China
7Wuhan Jin-yintan Hospital, Wuhan, China
8Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
9Shenzhen Third People’s Hospital, Shenzhen, China
10The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, China
11The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
12Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
13The Central Hospital of Wuhan, Wuhan, China
14Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China
15Chengdu Public Health Clinical Medical Center, Chengdu, China
16Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
17Wuhan Pulmonary Hospital, Wuhan, China
18Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
19The First Hospital of Changsha, Changsha, China
20The Third People's Hospital of Hainan Province, Sanya, China
21Huanggang Central Hospital, Huanggang, China
22Wenling First People's Hospital, Wenling, China
23The Third People's Hospital of Yichang, Yichang, China
24Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, China
25Xiantao First People's Hospital, Xiantao, China
26The People’s Hospital of Huangpi District, Wuhan, China

Tóm tắt

BackgroundThe coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide.ObjectiveTo evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status.MethodsWe 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.ResultsThe 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.ConclusionAmong 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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European Respiratory Journal

Tập 55 Số 5

2000547

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