Apollo Hospitals Educational and Research Foundation (AHERF), Apollo Hospitals, 500096, India.
Department of Biostatistics, Apollo Institute of Medical Sciences and Research (AIMSR), 500033, India.
Biomed Res Int. 2022 Apr 6;2022:2349890. doi: 10.1155/2022/2349890. eCollection 2022.
COVID-19 risk increases with comorbidities, and the effect is magnified due to the contribution of individual and combined comorbidities to the overall clinical outcomes. We aimed to explore the influence of demographic factors, clinical manifestations, and underlying comorbidities on mortality, severity, and hospital stay in COVID-19 patients. Therefore, retrospective chart reviews were performed to identify all laboratory-confirmed cases of SARS-CoV-2 infection in Apollo Hospitals, Hyderabad, between March 2020 and August 2020.A total of 369 confirmed SARS-CoV-2 cases were identified: 272 (73.7%) patients were male, and 97 (26.2%) were female. Of the confirmed cases, 218 (59.1%) had comorbidities, and 151 (40.9%) were devoid of comorbidities. This study showed that old age and underlying comorbidities significantly increase mortality, hospital stay, and severity due to COVID-19 infection. The presence of all four comorbidities, diabetes mellitus (DM) + Hypertension (HTN) + coronary artery disease (CAD) + chronic kidney disease (CKD), conferred the most severity (81%). The highest mortality (OR: 44.03, 95% CI: 8.64-224.27) was observed during the hospital stay (12.73 ± 11.38; 95% CI: 5.08-20.38) in the above group. Multivariate analysis revealed that nonsurvivors are highest (81%) in (DM + HTN + CAD + CKD) category with an odds ratio (95% CI) of 44.03 (8.64-224.27). Age, gender, and comorbidities adjusted odds ratio decreased to 20.25 (3.77-108.77). Median survival of 7 days was observed in the (DM + HTN + CAD + CKD) category. In summary, the presence of underlying comorbidities has contributed to a higher mortality rate, greater risk of severe disease, and extended hospitalization periods, hence, resulting in overall poorer clinical outcomes in hospitalized COVID-19 patients.
COVID-19 风险随着合并症而增加,由于个体和合并症对整体临床结果的贡献,这种影响被放大。我们旨在探讨人口统计学因素、临床表现和潜在合并症对 COVID-19 患者死亡率、严重程度和住院时间的影响。因此,进行了回顾性图表审查,以确定 2020 年 3 月至 2020 年 8 月在 Apollo 医院海得拉巴确诊的所有 SARS-CoV-2 感染病例。共确定了 369 例确诊的 SARS-CoV-2 病例:272 例(73.7%)患者为男性,97 例(26.2%)为女性。在确诊病例中,218 例(59.1%)有合并症,151 例(40.9%)无合并症。本研究表明,由于 COVID-19 感染,老年和潜在合并症显著增加死亡率、住院时间和严重程度。四种合并症(糖尿病、高血压、冠心病和慢性肾脏病)同时存在时,严重程度最高(81%)。在上述组中,住院期间(12.73±11.38;95%CI:5.08-20.38)观察到最高的死亡率(OR:44.03,95%CI:8.64-224.27)。多变量分析显示,非幸存者在(DM+HTN+CAD+CKD)组中最高(81%),优势比(95%CI)为 44.03(8.64-224.27)。年龄、性别和合并症调整后的优势比下降至 20.25(3.77-108.77)。在(DM+HTN+CAD+CKD)组中观察到 7 天的中位生存期。总之,潜在合并症的存在导致死亡率更高、疾病严重风险增加和住院时间延长,从而导致住院 COVID-19 患者的整体临床结局较差。