Heart disease and diabetes puts COVID-19 patients at more risk
This study reported that COVID-19 patients who had other diseases like hypertension, diabetes, lung, kidney and heart diseases were at more risk of severe illness, and these patients needed special care in hospitals.
Generally it is difficult and expensive to treat and care for patients with more than one disease or condition. These other underlying diseases or conditions are also referred to as comorbidities. Doctors report that even COVID-19 disease is worsened in patients with comorbidities.
The COVID-19 pandemic, which began in 2020, killed many people worldwide and hospitals were short of ICU beds for critical patients. For this reason, doctors were looking for ways to quickly identify patients who would need to be admitted in ICU.
In this study, researchers assessed how comorbidities really affected COVID-19 patients. They also looked into factors that could lead to patients staying in hospital for a long time, being admitted to ICU, or dying from COVID-19.
The researchers observed COVID-19 positive adults admitted in the 2 biggest hospitals in Egypt, and checked their health records for demographic data, laboratory tests results and chest X-ray results. They also recorded whether the patient completely recovered, was admitted in ICU, or died. The researchers compared the results for patients with comorbidities to those without.
The study found that over half of the patients had comorbidities, with heart disease and diabetes being the most common. Patients with comorbidities had worse laboratory results, and were less likely to recover from COVID-19.
Again, patients with comorbidities, especially heart diseases or diabetes, were most likely to be admitted in ICU and needed help with breathing. Results also showed that the elderly were more likely to die from COVID-19.
Of all the comorbidities studied here, researchers found that heart disease, hypertension and diabetes were the most risky, and linked this to old age. The researchers did not see any link between diabetes and the death of COVID-19 patients.
Previous studies had reported possible effects of underlying diseases, and this study confirmed that indeed multiple comorbidities increase COVID-19 disease risk and contribute to worse outcomes.
The researchers say that the results of this study might be limited because only a few of their patients had comorbidities of chronic liver, kidney, metabolic, neurological, endocrine, and autoimmune diseases. They said they observed some inconsistencies in hospital records, treatment protocol and admission policy during the study, which might have affected their results. The researchers also mentioned that the study ended before some of the patients’ outcomes were clear.
Researchers recommended future studies with a larger number of patients, wider varieties of comorbidities, and longer study periods.
Background and aims: The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 have consistently been reported as risk factors for unfavorable prognosis. We aim at this study to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for ICU admission or decease.
Methods: Four hundreds and thirty nine adult patients who are admitted through (June and July 2020) in Assiut and Aswan University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or Probable case. Detection of SARS-CoV-2 RNA was done by (TaqMan™ 2019-nCoV Control Kit v1 (Cat. No. A47532) supplied by QIAGEN, Germany on the Applied Biosystem 7500 Fast RT PCR System, USA.
Results: Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and LRT symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of CVD cases were admitted in ICU followed by DM cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 vs. 10.7%, P<0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% vs. 81%, P<0.001) and death rate was significantly higher in cases with comorbidities (P< 0.001). The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P<0.002 and 0.001 respectively).
Conclusion: Association of cardiovascular comorbid conditions including hypertension or neurological diseases together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.
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