König Sandra, Vaskyte Ugne, Boesing Maria, Lüthi-Corridori Giorgia, Leuppi Joerg Daniel
University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland.
Faculty of Medicine, University of Basel, 4056 Basel, Switzerland.
Viruses. 2025 Jul 7;17(7):957. doi: 10.3390/v17070957.
COVID-19 has led to significant global morbidity and mortality, with clinical outcomes varying widely among individuals. Understanding the impact of comorbidities on COVID-19 outcomes is essential for improving patient management. To date, analyses of comorbidities affecting COVID-19 severity in a heterogeneous Swiss cohort across multiple outbreak waves are unavailable. The objective of this study was to explore the role of comorbidities on COVID-19 severity in hospitalized patients from a diverse Swiss cohort and to evaluate the association between comorbidities and specific in-hospital complications.
This retrospective, observational, single-center study included adult patients who were hospitalized for COVID-19 for at least one night at the Cantonal Hospital Baselland, Switzerland (KSBL), between March 2020 and December 2021. Logistic regression analyses adjusted for age and gender were performed to analyze the association between comorbidities and critical condition (defined as severe disease or in-hospital death) and complications.
A total of 1124 patients were included in the study (median age 66, range 19-100 years, 60% male). A total of 76% of patients had at least one comorbidity. The most common comorbidities were arterial hypertension (47%), obesity (27%), and diabetes mellitus (24%). Overall, 16% of patients experienced a critical condition, and 25.5% had any type of complication. Patients without comorbidities had the lowest rates of critical condition (5.3%) and complications (10.2%). Obesity (OR 2.01, < 0.001), diabetes mellitus (OR 1.67, = 0.004), arterial hypertension (OR 1.65, = 0.006), arrhythmia (OR1.87, = 0.003), and chronic obstructive pulmonary disease (OR 2.72, < 0.001) were found to be associated with critical condition. The most frequently observed complication was acute kidney failure, affecting 17.1% of the study population, while patients with arrhythmia showed the highest overall complication rate (42%).
Our findings are consistent with previous research, confirming the relevance of specific comorbidities as key risk factors for critical COVID-19 outcomes. Among all comorbid conditions evaluated, asthma appeared to have the least impact on disease severity. Future research should focus on the impact of the combination of comorbidities on the disease severity of COVID-19, as well as the long-term effects of COVID-19 for patients with certain comorbidities.
新型冠状病毒肺炎（COVID-19）已导致全球大量发病和死亡，个体的临床结局差异很大。了解合并症对COVID-19结局的影响对于改善患者管理至关重要。迄今为止，尚无关于多轮疫情期间影响瑞士异质队列中COVID-19严重程度的合并症分析。本研究的目的是探讨合并症在瑞士不同队列住院患者中对COVID-19严重程度的作用，并评估合并症与特定院内并发症之间的关联。
这项回顾性、观察性、单中心研究纳入了2020年3月至2021年12月期间在瑞士巴塞尔兰州立医院（KSBL）因COVID-19住院至少一晚的成年患者。进行了调整年龄和性别的逻辑回归分析，以分析合并症与危重症（定义为重症疾病或院内死亡）及并发症之间的关联。
共有1124例患者纳入研究（中位年龄66岁，范围19 - 100岁，60%为男性）。共有76%的患者至少有一种合并症。最常见的合并症是动脉高血压（47%）、肥胖（27%）和糖尿病（24%）。总体而言，16%的患者出现危重症，25.5%的患者出现任何类型的并发症。无合并症的患者危重症发生率（5.3%）和并发症发生率（10.2%）最低。肥胖（比值比[OR] 2.01，P < 0.001）、糖尿病（OR 1.67，P = 0.004）、动脉高血压（OR 1.65，P = 0.006）、心律失常（OR 1.87，P = 0.003）和慢性阻塞性肺疾病（OR 2.72，P < 0.001）与危重症相关。最常观察到的并发症是急性肾衰竭，影响了17.1%的研究人群，而心律失常患者的总体并发症发生率最高（42%）。
我们的研究结果与先前的研究一致，证实了特定合并症作为COVID-19危重症结局关键危险因素的相关性。在所有评估的合并症中，哮喘似乎对疾病严重程度影响最小。未来的研究应关注合并症组合对COVID-19疾病严重程度的影响，以及COVID-19对某些合并症患者的长期影响。
