Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis
Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis
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DOI：
10.1183/13993003.00547-2020
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发表时间：
2020-05-01
影响因子：
24.3
通讯作者：
He, Jian-xing
中科院分区：
文献类型：
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作者：
Guan, Wei-jie;Liang, Wen-hua;He, Jian-xing
背景：2019冠状病毒病（COVID - 19）疫情在全球迅速蔓延。
目的：通过对合并症情况进行分层，评估COVID - 19患者出现严重不良结局的风险。
方法：我们分析了2019年12月11日至2020年1月31日期间中国大陆31个省/自治区/直辖市575家医院的1590例实验室确诊的住院患者的数据。我们分析了复合终点，包括入住重症监护病房、有创通气或死亡。根据合并症的存在与否及数量比较了达到复合终点的风险。
结果：平均年龄为48.9岁，686例（42.7%）患者为女性。重症病例占研究人群的16.0%。131例（8.2%）患者达到复合终点。399例（25.1%）报告至少有一种合并症。最常见的合并症是高血压（16.9%），其次是糖尿病（8.2%）。130例（8.2%）患者报告有两种或更多合并症。在对年龄和吸烟状况进行调整后，慢性阻塞性肺疾病（风险比（95%置信区间）2.681（1.424 - 5.048））、糖尿病（1.59（1.03 - 2.45））、高血压（1.58（1.07 - 2.32））和恶性肿瘤（3.50（1.60 - 7.64））是达到复合终点的危险因素。至少有一种合并症的患者风险比（95%置信区间）为1.79（1.16 - 2.77），有两种或更多合并症的患者为2.59（1.61 - 4.17）。
结论：在COVID - 19实验室确诊病例中，有任何合并症的患者比无合并症的患者临床结局更差。合并症数量越多，临床结局也越差。
Background: The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide.Objective: To evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status.Methods: We analysed data from 1590 laboratory confirmed hospitalised patients from 575 hospitals in 31 provinces/autonomous regions/provincial municipalities across mainland China between 11 December 2019 and 31 January 2020. We analysed the composite end-points, which consisted of admission to an intensive care unit, invasive ventilation or death. The risk of reaching the composite end-points was compared according to the presence and number of comorbidities.Results: The mean age was 48.9 years and 686 (42.7%) patients were female. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached the composite end-points. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD (HR (95% CI) 2.681 (1.424-5.048)), diabetes (1.59 (1.032.45)), hypertension (1.58 (1.07-2.32)) and malignancy (3.50 (1.60-7.64)) were risk factors of reaching the composite end-points. The hazard ratio (95% CI) was 1.79 (1.16-2.77) among patients with at least one comorbidity and 2.59 (1.61 4.17) among patients with two or more comorbidities.Conclusion: Among laboratory confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes.