Liu Hong, Chen Shiyan, Liu Min, Nie Hao, Lu Hongyun
1Department of Nutrition, the Third Xiangya Hospital of Central South University, Changsha, China.
2Department of Endocrinology & Metabolism, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Aging Dis. 2020 May 9;11(3):668-678. doi: 10.14336/AD.2020.0502. eCollection 2020 May.
Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. In order to explore the effects of comorbid chronic diseases on clinical outcomes of COVID-19, a search was conducted in PubMed, Ovid MEDLINE, EMBASE, CDC, and NIH databases to April 25, 2020. A total of 24 peer-reviewed articles, including 10948 COVID-19 cases were selected. We found diabetes was present in 10.0%, coronary artery disease/cardiovascular disease (CAD/CVD) was in 8.0%, and hypertension was in 20.0%, which were much higher than that of chronic pulmonary disease (3.0%). Specifically, preexisting chronic conditions are strongly correlated with disease severity [Odds ratio (OR) 3.50, 95% CI 1.78 to 6.90], and being admitted to intensive care unit (ICU) (OR 3.36, 95% CI 1.67 to 6.76); in addition, compared to COVID-19 patients with no preexisting chronic diseases, COVID-19 patients who present with either diabetes, hypertension, CAD/CVD, or chronic pulmonary disease have a higher risk of developing severe disease, with an OR of 2.61 (95% CI 1.93 to 3.52), 2.84 (95% CI 2.22 to 3.63), 4.18 (95% CI 2.87 to 6.09) and 3.83 (95% CI 2.15 to 6.80), respectively. Surprisingly, we found no correlation between chronic conditions and increased risk of mortality (OR 2.09, 95% CI 0.26 to16.67). Taken together, cardio-metabolic diseases, such as diabetes, hypertension and CAD/CVD were more common than chronic pulmonary disease in COVID-19 patients, however, each comorbid disease was correlated with increased disease severity. After active treatment, increased risk of mortality in patients with preexisting chronic diseases may reduce.
自2019年12月以来，2019冠状病毒病（COVID-19）已在全球范围内导致了相当高的发病率和死亡率。为了探究合并慢性疾病对COVID-19临床结局的影响，我们在PubMed、Ovid MEDLINE、EMBASE、疾病控制与预防中心（CDC）及美国国立卫生研究院（NIH）数据库中进行检索，检索截至2020年4月25日的文献。共筛选出24篇经同行评审的文章，包含10948例COVID-19病例。我们发现，10.0%的患者患有糖尿病，8.0%患有冠状动脉疾病/心血管疾病（CAD/CVD），20.0%患有高血压，这些比例均远高于慢性肺病患者的比例（3.0%）。具体而言，既往存在的慢性疾病与疾病严重程度密切相关[比值比（OR）3.50，95%置信区间（CI）为1.78至6.90]，且与入住重症监护病房（ICU）相关（OR 3.36，95% CI为1.67至6.76）；此外，与无既往慢性疾病的COVID-19患者相比，患有糖尿病、高血压、CAD/CVD或慢性肺病的COVID-19患者发生重症的风险更高，其OR分别为2.61（95% CI为1.93至3.52）、2.84（95% CI为2.22至3.63）、4.18（95% CI为2.87至6.09）和3.83（95% CI为2.15至6.80）。令人惊讶的是，我们发现慢性疾病与死亡风险增加之间并无关联（OR 2.09，95% CI为0.26至16.67）。总体而言，在COVID-19患者中，糖尿病、高血压和CAD/CVD等心血管代谢疾病比慢性肺病更为常见，然而，每种合并疾病均与疾病严重程度增加相关。经过积极治疗后，既往存在慢性疾病患者的死亡风险增加情况可能会降低。
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