Impact of comorbidities on patients with COVID-19: A large retrospective study in Zhejiang, China
Impact of comorbidities on patients with COVID-19: A large retrospective study in Zhejiang, China
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DOI：
10.1002/jmv.26183
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发表时间：
2020-06-29
影响因子：
12.7
通讯作者：
Yang, Yida
中科院分区：
文献类型：
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作者：
Ye, Chanyuan;Zhang, Shanyan;Yang, Yida
2019 年冠状病毒病（COVID-19）已成为全球严重的公共卫生问题。在这里，我们根据 COVID-19 患者的合并症对他们进行分层，以评估他们发生严重不良后果的风险。我们收集了2020年1月17日至2月7日浙江省856例确诊为COVID-19的住院病例，分析了他们的合并症和复合终点（包括因疾病进展、休克、有创通气和死亡而入住重症监护室），以确定合并症与不良结局之间的关系。患者的中位年龄为 46 (36-56) 岁； 439 名 (51.3%) 为男性，242 名 (28.3%) 患有合并症，152 名 (17.8%) 患有两种或多种合并症。最常见的合并症是高血压（142 例[16.6%]），其次是糖尿病（64 例[7.5%]）。 856例患者中，重症病例154例（18.0%）。 32 例 (3.7%) 达到复合终点，其中 22 例 (9.1%) 来自合并症组，10 例 (1.6%) 来自非合并症组 (P < .001)。调整年龄和性别状态后，有合并症组达到复合终点的风险高于无合并症组（风险比 [HR] 3.04，95% 置信区间 [CI]：1.40-6.60）。患有一种、两种和三种或多种合并症的患者的 HR 值分别为 1.61 (95% CI: 0.44-5.91)、3.44 (95% CI: 1.31-9.08) 和 6.90 (95% CI: 2.69-17.69)。与没有任何合并症的患者相比，有合并症的 COVID-19 患者的临床结果更差。合并症数量越多，出现严重不良后果的风险就越大。
Coronavirus disease 2019 (COVID-19) has become a serious public health problem worldwide. Here, we stratified COVID-19 patients based on their comorbidities to assess their risk of serious adverse outcomes. We collected 856 hospitalized cases diagnosed with COVID-19 from 17 January to 7 February 2020, in Zhejiang Province, and analyzed their comorbidities and composite endpoint (including admission to intensive care unit owing to disease progression, shock, invasive ventilation, and death) to determine the relationship between comorbidities and adverse outcomes. The median age of patients was 46 (36-56) years; 439 (51.3%) were men, 242 (28.3%) had comorbidities, and 152 (17.8%) had two or more comorbidities. The most common comorbidity was hypertension (142 [16.6%]), followed by diabetes (64 [7.5%]). Of the 856 patients, there are 154 (18.0%) severe cases. Thirty-two (3.7%) reached composite endpoints, of which 22 (9.1%) were from the comorbidity group and 10 (1.6%) from the non-comorbidity group (P < .001). After adjusting for age and gender status, the risk of reaching the composite endpoint was higher in the group with comorbidity than in that without comorbidity (hazard ratio [HR] 3.04, 95% confidence interval [CI]: 1.40-6.60). HR values for patients with one, two, and three or more comorbidities were 1.61 (95% CI: 0.44-5.91), 3.44 (95% CI: 1.31-9.08), and 6.90 (95% CI: 2.69-17.69), respectively. COVID-19 patients with comorbidities had worse clinical outcomes as compared with those without any comorbidity. The higher the number of comorbidities, the greater was the risk of serious adverse outcomes.