Variable effects of underlying diseases on the prognosis of patients with COVID-19

Abstract

Underlying diseases might be risk factors for poor prognosis in patients with coronavirus disease (COVID-19); however, we still do not know whether these diseases are independent factors affecting prognosis, which type of underlying diseases are risk factors, and which type of clinical outcomes are affected. We retrospectively reviewed cohort data from 7,590 de-identified patients with COVID-19 who were diagnosed using severe acute respiratory syndrome-coronavirus-2 RNA polymerase chain reaction test up to May 15, 2020. We used linked-medical claims data provided by the Health Insurance Review and Assessment Service in South Korea. Underlying diseases were identified using the diagnostic codes in the patients’ files from January 1, 2019 to December 31, 2019. The total mortality rate was 3.0% in patients with COVID-19. After adjusting for age, sex, and concomitant chronic conditions, we found that congestive heart failure, chronic pulmonary diseases, diabetes without chronic complications, renal diseases, and malignancy were factors that significantly increased the cost of treatment. Cerebrovascular disease, chronic pulmonary disease, and paralysis were found to be independent factors significant in prolonging hospital stay. Diabetes with chronic complications was independently associated with intensive care unit admission. In addition, underlying congestive heart failure (odds ratio [OR], 1.724; P = 0.003), dementia (OR, 1.598; P = 0.012), diabetes with and without chronic complications (OR, 1.821; P = 0.002 and OR, 1.518; P = 0.022, respectively), renal disease (OR, 2.299; P = 0.002), and malignancy (OR, 1.529; P = 0.039) were significant factors associated with death, even after adjustments. Underlying diseases were significant independent factors of the poor prognosis in patients with COVID-19. The effects were variable according to the type of underlying disease and clinical outcome. Therefore, patients with COVID-19 with underlying diseases should be monitored more closely because they are more at risk of a poor prognosis.

Predicting the Risk Factors Associated With Severe Outcomes Among COVID-19 Patients–Decision Tree Modeling Approach

“…Our findings are consistent with the current literature, where the majority of poor outcomes are noted among the older populations ( 3 , 8 , 25 ) and individuals with underlying conditions ( 6 ). A model based on age and other clinical variables predicted death among COVID-19 patients in China ( 8 ).…”

Whether Urbanization Has Intensified the Spread of Infectious Diseases—Renewed Question by the COVID-19 Pandemic

“…Secondly, the morbidity and mortality of Category A and B are used to reflect the spread of infectious diseases. The morbidity and mortality of Category A and B infectious diseases are significantly different from the population mortality ( 2 ), life expectancy per capita ( 3 ), newborn mortality ( 4 ), and prevalence of underlying diseases ( 5 , 6 ) in the previous literatures. The former belongs to infectious diseases, which have the characteristics of “human-to-human transmission.” It is more easily to measure the spread of infectious diseases.…”

Suspected COVID-19 Cases Admitted in a Tertiary Care Hospital. Correlation of Demographic and Clinical Characteristics with Viral Load Results and Hospitalization

“…Underlying diseases might be risk factors for poor prognosis in patients with COVID-19 infection. Current knowledge has shown that death rate is high in people with chronic underlying diseases [27], [28]. In our study, 989 patients (79,5%) had no underlying diseases, while 12,6% had an underlying disease, such as hypertension, cardiovascular diseases, diabetes mellitus, malignancy, and chronic kidney disease.…”