Vishnoi Ramnivas, Gaba Manish, Kumar Naveen, Pandey Ankita, Dewan Arun
Internal Medicine, Max Smart Super Speciality Hospital, New Delhi, IND.
Cureus. 2024 Dec 3;16(12):e75042. doi: 10.7759/cureus.75042. eCollection 2024 Dec.
Background Numerous risk factors have been identified for developing severe COVID-19, including sociodemographic variables and concomitant diseases. Individuals with underlying comorbidities such as diabetes, hypertension, asthma, and coronary artery disease are at a greater risk of severe illness and death. This study aimed to observe the association between risk factors and the severity of COVID-19. Methodology A single-center, hospital-based, prospective, observational study was conducted at Max Smart Super Speciality Hospital in Saket, Delhi from October 2020 to December 2021. A total of 1,454 patients admitted under our care in the Department of Internal Medicine were included in this study. Patients were divided into the following three groups: patients without comorbidities, patients with a single comorbidity, and patients with multiple comorbidities. The risk factors under evaluation were age >50 years, obesity, diabetes, hypertension, chronic kidney disease (CKD), heart disease, chronic liver disease (CLD), and immunocompromised status (human immunodeficiency virus, post-transplant, malignancy undergoing chemotherapy). Results In this study, 28.1% (n = 408) of patients did not have comorbidities, 30.1% (n = 438) of patients had a single comorbidity, and 41.8% (n = 608) of patients had multiple comorbidities. Regarding risk factors, 62% (n = 872) of patients were aged >50 years, 7.4% (n = 108) were obese, 30.7% (n = 447) had diabetes, 33% (n = 480) were hypertensive, 1.2% (n = 18) had CKD, 6.8% (n = 99) had heart disease, 0.3% (n = 4) had CLD, and 5.5% (n = 80) were immunocompromised. A statistically significant association was found between increasing age and worsening severity of COVID-19 (p = 0.0001), male gender (p = 0.0001), presence of comorbidities, including diabetes, hypertension, obesity, CKD, CLD, heart disease (p = 0.0001). Patients in the immunocompromised group did not have a statistically significant association with disease severity. A statistically significant association was found between mortality and severity of COVID-19. Overall, 16.7% (n = 48) of the patients in the no comorbidity group, 35.4% (n = 102) in the single comorbidity group, and 47.9% (n = 138) in the multiple comorbidity group (p = 0.0001) presented with severe disease on admission. Conclusions The study shows that the severity of the disease increased as the number of risk factors increased. This information can help us take early and active measures in these groups of patients with multiple comorbid illnesses.
已确定多种导致重症新型冠状病毒肺炎（COVID-19）的风险因素，包括社会人口学变量和合并症。患有潜在合并症，如糖尿病、高血压、哮喘和冠状动脉疾病的个体，患重症疾病和死亡的风险更高。本研究旨在观察风险因素与COVID-19严重程度之间的关联。
2020年10月至2021年12月，在德里萨克特的马克斯·斯马特超级专科医院进行了一项单中心、基于医院的前瞻性观察性研究。本研究纳入了内科接受我们治疗的1454例患者。患者分为以下三组：无合并症患者、患有单一合并症患者和患有多种合并症患者。评估的风险因素包括年龄>50岁、肥胖、糖尿病、高血压、慢性肾脏病（CKD）、心脏病、慢性肝病（CLD）和免疫功能低下状态（人类免疫缺陷病毒、移植后、正在接受化疗的恶性肿瘤）。
本研究中，28.1%（n = 408）的患者无合并症，30.1%（n = 438）的患者患有单一合并症，41.8%（n = 608）的患者患有多种合并症。关于风险因素，62%（n = 872）的患者年龄>50岁，7.4%（n = 108）为肥胖，30.7%（n = 447）患有糖尿病，33%（n = 480）患有高血压，1.2%（n = 18）患有CKD，6.8%（n = 99）患有心脏病，0.3%（n = 4）患有CLD，5.5%（n = 80）免疫功能低下。发现年龄增加与COVID-19严重程度加重之间存在统计学显著关联（p = 0.0001），男性（p = 0.0001）、合并症的存在，包括糖尿病、高血压、肥胖、CKD、CLD、心脏病（p = 0.0001）。免疫功能低下组患者与疾病严重程度之间无统计学显著关联。发现死亡率与COVID-19严重程度之间存在统计学显著关联。总体而言，无合并症组16.7%（n = 48）的患者、单一合并症组35.4%（n = 102）的患者和多种合并症组47.9%（n = 138）的患者（p = 0.0001）入院时表现为重症疾病。
该研究表明，随着风险因素数量的增加，疾病严重程度增加。这些信息有助于我们对这些患有多种合并症的患者群体采取早期积极措施。
