Multimorbidity patterns among COVID-19 deaths: proposal for the construction of etiological models

Abstract

Objectives. To describe patterns of multimorbidity among fatal cases of COVID-19, and to propose a classification of patients based on age and multimorbidity patterns to begin the construction of etiological models. Methods. Data of Colombian confirmed deaths of COVID-19 until June 11, 2020, were included in this analysis (n=1488 deaths). Relationships between COVID-19, combinations of health conditions and age were explored using locally weighted polynomial regressions. Results. The most frequent health conditions were high blood pressure, respiratory disease, diabetes, cardiovascular disease, and kidney disease. Dyads more frequents were high blood pressure with diabetes, cardiovascular disease or respiratory disease. Some multimorbidity patterns increase probability of death among older individuals, whereas other patterns are not age-related, or decrease the probability of death among older people. Not all multimorbidity increases with age, as is commonly thought. Obesity, alone or with other diseases, was associated with a higher risk of severity among young people, while the risk of the high blood pressure/diabetes dyad tends to have an inverted U distribution in relation with age. Conclusions. Classification of individuals according to multimorbidity in the medical management of COVID-19 patients is important to determine the possible etiological models and to define patient triage for hospitalization. Moreover, identification of non-infected individuals with high-risk ages and multimorbidity patterns serves to define possible interventions of selective confinement or special management.

Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients

“…Few studies to date have explored the combined and additional effect of obesity on COVID-19 severity. 13 31 A study investigated the patterns of multimorbidity among fatal cases of COVID-19 in Colombia. 31 Similar to our study, the authors found that obesity alone or with other diseases was associated with a higher risk of COVID-19 fatality among young people.…”

“…13 31 A study investigated the patterns of multimorbidity among fatal cases of COVID-19 in Colombia. 31 Similar to our study, the authors found that obesity alone or with other diseases was associated with a higher risk of COVID-19 fatality among young people. Furthermore, a populationbased study in Mexico observed that the addition of obesity to any number of comorbidities significantly Open access increased the risk of COVID-19 lethality.…”

Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study

“…Frailty has been linked to infection, 16 severity, 16 17 geographic differences in severity and mortality by MM, 18 prompting a renewed focus on improving global health and access to care, probabilistic modelling, 19 the triage of care and shielding of the most vulnerable. 20 This study presents an important contribution to this developing literature with a comprehensive set of prevalence estimates for MM in eastern Europe. MM is a growing global health problem affecting all nations regardless of wealth.…”

Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21,773 Brazilian adult and elderly inpatients

“…Few studies to-date have explored the combined and additional effect of obesity on COVID-19 severity. 13,28 A study investigated the patterns of multimorbidity among fatal cases of COVID-19 in Colombia. 28 Similar to our study, the authors found that obesity alone or with other diseases was associated with a higher risk of COVID-19 fatality among young people.…”

“…13,28 A study investigated the patterns of multimorbidity among fatal cases of COVID-19 in Colombia. 28 Similar to our study, the authors found that obesity alone or with other diseases was associated with a higher risk of COVID-19 fatality among young people. Furthermore, a population-based study in Mexico observed that the addition of obesity to any number of comorbidities significantly increased the risk of COVID-19 lethality.…”