Impact of comorbidities on hospitalised Syrian patients with COVID-19: a retrospective study

Abstract

ObjectivesThis study aims to compare the clinical manifestations, laboratory findings, outcomes and overall survival time of patients with COVID-19 with and without comorbidities.DesignRetrospective design.SettingThis study was undertaken at two hospitals in Damascus.ParticipantsA total of 515 Syrian patients met the inclusion criterion, laboratory-confirmed COVID-19 infection following the Centers for Disease Control and Prevention. Exclusion criteria were suspected and probable cases that were not confirmed with a positive reverse transcription-PCR assay, and patients who self-discharged from the hospital against medical advice.Primary and secondary outcome measuresFirst, assess the impacts of comorbidities on COVID-19 infection in four areas (clinical manifestations, laboratory findings, severity and outcomes). Second, calculate the overall survival time for patients with COVID-19 with comorbidities.ResultsOf 515 patients included, 316 (61.4%) were male and 347 (67.4%) had at least one coexisting chronic disease. Patients with comorbidities compared with no comorbidities were more vulnerable to poor outcomes such as severe infection (32.0% vs 9.5%, p<0.001), severe complications (34.6% vs 9.5%, p<0.001), the need for mechanical ventilation (28.8% vs 7.7%, p<0.001) and death (32.0% vs 8.3%, p<0.001). Multiple logistic regression showed that age ≥65 years old, positive smoking history, having ≥2 comorbidities and chronic obstructive pulmonary disease were risk factors linked to severe COVID-19 infection in patients with comorbidities. Overall survival time was lower among patients with comorbidities (vs no comorbidities), patients with ≥2 comorbidities (vs one comorbidity), and patients with hypertension, chronic obstructive pulmonary disease, malignancy or obesity (vs other comorbidities) (p<0.05).ConclusionThis study revealed that COVID-19 infection had poor outcomes among those with comorbidities. Severe complications, mechanical ventilation usage and death were more prevalent among patients with comorbidities compared with those with no comorbidities.

Survival analysis of diabetes mellitus and cardiovascular patients with COVID-19: a secondary data analysis

“…These findings reinforce previous studies linking these comorbidities to adverse outcomes of COVID-19 as independent predictors of mortality (Imam et al, 2020;Piskač Živković et al, 2022;Ssentongo et al, 2020). Studies in Syria (Najjar et al, 2023), Egypt (Albadawy et al, 2021), and India (Saurabh ) reported lower survival rates in COVID-19 patients with comorbidities. The study showed that COVID-19 patients with cardiovascular system problems were associated with survival rates before and after adjusting for respondent characteristics.…”

“…DM is also correlated with glycemic instability and impaired immune response, which coincides with obesity and heart disease (Kandil et al, 2021), thereby leading to lung dysfunction, such as decreased lung volume (Yan et al, 2020). Typical DM complications such as cardiovascular disease and chronic obstructive pulmonary disease, especially when accompanied by other comorbidities, significantly increase the risk of death in COVID-19 patients (Lim et al, 2021;Najjar et al, 2023). Bello-Chavolla et al supported this by noting that DM was associated with a threefold increased risk of death from COVID-19 after adjusting for age, sex, and comorbidities (Bello-Chavolla et al, 2020).…”