Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China.
Biomed Environ Sci. 2020 Dec 20;33(12):893-905. doi: 10.3967/bes2020.123.
Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.
A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( ) and 95% confidence interval (95% ) of the associations between comorbidities (cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19.
Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.
Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
一些 COVID-19 患者存在重叠的合并症。每个导致 COVID-19 风险的成分的独立作用尚不清楚，一些非心血管合并症如何影响 COVID-19 的风险也尚不清楚。
采用回顾性随访设计。从中国九个省份共招募了 1160 名经实验室确诊的患者。合并症数据来自患者的病历。多变量逻辑回归模型用于估计合并症（心血管或非心血管疾病）、临床严重程度与 COVID-19 治疗结局之间的关联的比值比（OR）和 95%置信区间（95%CI）。
共有 158 例（13.6%）患者被诊断为重症，32 例（2.7%）患者结局不良。高血压（2.87，1.30-6.32）、2 型糖尿病（T2DM）（3.57，2.32-5.49）、心血管疾病（CVD）（3.78，1.81-7.89）、脂肪肝疾病（7.53，1.96-28.96）、高脂血症（2.15，1.26-3.67）、其他肺部疾病（6.00，3.01-11.96）和电解质失衡（10.40，3.00-26.10）与重症风险增加独立相关。T2DM（6.07，2.89-12.75）、CVD（8.47，6.03-11.89）和电解质失衡（19.44，11.47-32.96）也是结局不良的强预测因素。有合并症的女性在入院时更有可能患有严重疾病（5.46，3.25-9.19），而有合并症的男性在两周内更有可能出现不良治疗结局（6.58，1.46-29.64）。
除了高血压、糖尿病和 CVD 外，脂肪肝疾病、高脂血症、其他肺部疾病和电解质失衡也是 COVID-19 严重程度和治疗结局不良的独立危险因素。有合并症的女性更有可能患有严重疾病，而有合并症的男性更有可能出现不良治疗结局。
