Association of Comorbidities with COVID-19 Outcomes

摘要

Risk for unfavorable outcome varies with type and increases with number of comorbidities. The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Older age and comorbidities have consistently been reported as risk factors for unfavorable prognosis; less clear so far has been how the number and types of comorbidities influence the outcome. Clarification now comes from a nationwide Chinese retrospective cohort study involving 1590 PCR-confirmed COVID-19 cases (mean age, 49 years; 43% female) diagnosed between December 11,2019, and January 31,2020. The most common symptoms were fever, dry cough, and fatigue (88%, 70%, and 43%, respectively). The mean incubation period was 4 days. According to the 2007 American Thoracic Society/Infectious Disease Society of America guideline for community-acquired pneumonia criteria, 16% of the cases were considered severe. Reported proportions with comorbidities included 17% hypertension, 8% diabetes, 4% cardiovascular disease, 2% cerebrovascular disease, 2% chronic obstructive pulmonary disease (COPD), 1% chronic kidney disease, and 1% malignancy. At least one comorbidity was significantly more common in severe than in nonsevere cases (33% vs. 10%). Patients with >1 comorbidity were older (61 vs. 45 years), and more often had shortness of breath (41% vs. 18%), nausea or vomiting (10% vs. 4%), and an abnormal chest x-ray (29% vs. 15%), whereas abnormal CT scans were similarly frequent (71%).