Lee Kyunghee, Hwang Jieun
Department of Healthcare Management, Eulji University of Korea, 553 Sanseongdaero, Sujeong-gu, Seongnam city, Kyeonggi-do, 13135, Republic of Korea.
Department of Health Administration, College of Health Science, Dankook University, 119 Dandaero, Dongnam-gu, Cheonan city, Chungcheongnam-do, 31116, Republic of Korea.
Arch Public Health. 2025 Jan 23;83(1):20. doi: 10.1186/s13690-025-01509-3.
Comorbidities or complications significantly influence coronavirus disease-2019 (COVID-19) severity and mortality risk. Therefore, this study aimed to compare treatment outcomes of COVID-19 inpatients by underlying diseases or complications.
Data on COVID-19 patients from the National Health Insurance Service customized research database were analyzed while focusing on eight underlying diseases and complications: diabetes, hypertension, heart disease, kidney disease, liver disease, dementia, depression, and respiratory disease.
Of the 377,812 COVID-19 patients in 2021, 51.47% were male and 48.53% were female, and post-diagnosis mortality was 2.04%; 68.7% (n = 259,560) of patients had at least one underlying condition, with the following frequency: respiratory disease (78.88%), heart disease (33.84%), hypertension (30.29%), liver disease (21.38%), depression (9.32%), kidney disease (4.89%), and dementia (3.87%). Among patients without any underlying diseases, 19.8% (n = 74,925) were treated for post-diagnosis complications, with the following frequency: respiratory disease (89.21%), liver disease (19.12%), heart disease (14.90%), diabetes (10.37%), hypertension (8.22%), depression (3.86%), kidney disease (2.04%), and dementia (0.64%). Except for liver disease, all underlying diseases were associated with mortality. COVID-19 patients with diabetes exhibited a 1.42-fold higher mortality risk (95% confidence interval [CI ]1.35-1.50). All complications were associated with death, with kidney-related complications conferring a 4.84-fold higher mortality risk (95% CI 3.62-6.48).
Underlying diseases and complications in COVID-19 patients were associated with death. Even with the same disease, the timing of onset, before or after COVID-19 diagnosis, induced a difference in the mortality risk. Both underlying diseases and complications should be considered for more proactive medical interventions.
合并症或并发症会显著影响2019冠状病毒病（COVID-19）的严重程度和死亡风险。因此，本研究旨在比较伴有基础疾病或并发症的COVID-19住院患者的治疗结果。
分析了来自国民健康保险服务定制研究数据库的COVID-19患者数据，重点关注八种基础疾病和并发症：糖尿病、高血压、心脏病、肾病、肝病、痴呆症、抑郁症和呼吸系统疾病。
2021年的377,812例COVID-19患者中，男性占51.47%，女性占48.53%，诊断后死亡率为2.04%；68.7%（n = 259,560）的患者至少有一种基础疾病，其出现频率如下：呼吸系统疾病（78.88%）、心脏病（33.84%）、高血压（30.29%）、肝病（21.38%）、抑郁症（9.32%）、肾病（4.89%）和痴呆症（3.87%）。在没有任何基础疾病的患者中，19.8%（n = 74,925）接受了诊断后并发症的治疗，其出现频率如下：呼吸系统疾病（89.21%）、肝病（19.12%）、心脏病（14.90%）、糖尿病（10.37%）、高血压（8.22%）、抑郁症（3.86%）、肾病（2.04%）和痴呆症（0.64%）。除肝病外，所有基础疾病均与死亡率相关。患有糖尿病的COVID-19患者的死亡风险高1.42倍（95%置信区间[CI]1.35 - 1.50）。所有并发症均与死亡相关，与肾脏相关的并发症使死亡风险高4.84倍（95%CI 3.62 - 6.48）。
COVID-19患者的基础疾病和并发症与死亡相关。即使是同一种疾病，发病时间在COVID-19诊断之前或之后，也会导致死亡风险的差异。在进行更积极的医疗干预时，应同时考虑基础疾病和并发症。
