Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China.

Yan MA; Dong Shan Zhu; Ren Bo Chen; Nan Nan Shi; Si Hong Liu; Yi Pin Fan; Gui Hui WU; Pu Ye Yang; Jiang Feng Bai; Hong Chen; Li Ying Chen; Qiao Feng; Tuan Mao Guo; Yong Hou; Gui Fen HU; Xiao Mei HU; Yun Hong HU; Jin Huang; Qiu Hua Huang; Shao Zhen Huang; Liang JI; Hai Hao Jin; Xiao Lei; Chun Yan LI; Min Qing LI; Qun Tang LI; Xian Yong LI; Hong De Liu; Jin Ping Liu; Zhang Liu; Yu Ting MA; Ya Mao; Liu Fen MO; Hui NA; Jing Wei Wang; Fang Li Song; Sheng Sun; Dong Ting Wang; Ming Xuan Wang; Xiao Yan Wang; Yin Zhen Wang; Yu Dong Wang; Wei WU; Lan Ping WU; Yan Hua Xiao; Hai Jun Xie; Hong Ming XU; Shou Fang XU; Rui Xia Xue; Chun Yang; Kai Jun Yang; Sheng Li Yuan; Gong Qi Zhang; Jin Bo Zhang; Lin Song Zhang; Shu Sen Zhao; Wan Ying Zhao; Kai Zheng; Ying Chun Zhou; Jun Teng Zhu; Tian Qing Zhu; Hua Min Zhang; Yan Ping Wang; Yong Yan Wang

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Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China.

Author: Yan MA ¹ ; Dong Shan ZHU ² ; Ren Bo CHEN ¹ ; Nan Nan SHI ¹ ; Si Hong LIU ³ ; Yi Pin FAN ¹ ; Gui Hui WU ⁴ ; Pu Ye YANG ⁵ ; Jiang Feng BAI ⁶ ; Hong CHEN ⁷ ; Li Ying CHEN ⁸ ; Qiao FENG ⁹ ; Tuan Mao GUO ¹⁰ ; Yong HOU ¹¹ ; Gui Fen HU ¹² ; Xiao Mei HU ¹³ ; Yun Hong HU ¹⁴ ; Jin HUANG ¹⁵ ; Qiu Hua HUANG ¹⁵ ; Shao Zhen HUANG ¹⁶ ; Liang JI ¹⁷ ; Hai Hao JIN ¹⁸ ; Xiao LEI ¹⁹ ; Chun Yan LI ²⁰ ; Min Qing LI ²¹ ; Qun Tang LI ²² ; Xian Yong LI ²³ ; Hong De LIU ²⁴ ; Jin Ping LIU ²⁵ ; Zhang LIU ²⁶ ; Yu Ting MA ²⁷ ; Ya MAO ²⁸ ; Liu Fen MO ²⁹ ; Hui NA ³⁰ ; Jing Wei WANG ³⁰ ; Fang Li SONG ³¹ ; Sheng SUN ³² ; Dong Ting WANG ³³ ; Ming Xuan WANG ³⁴ ; Xiao Yan WANG ³⁵ ; Yin Zhen WANG ³⁶ ; Yu Dong WANG ³⁷ ; Wei WU ³⁸ ; Lan Ping WU ³⁹ ; Yan Hua XIAO ⁴⁰ ; Hai Jun XIE ⁴¹ ; Hong Ming XU ⁴² ; Shou Fang XU ⁴³ ; Rui Xia XUE ⁴⁴ ; Chun YANG ⁴⁵ ; Kai Jun YANG ⁴⁶ ; Sheng Li YUAN ⁴⁷ ; Gong Qi ZHANG ⁴⁸ ; Jin Bo ZHANG ⁴⁹ ; Lin Song ZHANG ⁵⁰ ; Shu Sen ZHAO ⁵¹ ; Wan Ying ZHAO ⁵² ; Kai ZHENG ⁵³ ; Ying Chun ZHOU ⁵⁴ ; Jun Teng ZHU ⁵⁵ ; Tian Qing ZHU ⁵⁶ ; Hua Min ZHANG ^{57
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58} ; Yan Ping WANG ¹ ; Yong Yan WANG ¹
Author Information

1. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
2. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China.
3. Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
4. Department of Tuberculosis, The Public Health Clinical Center of Chengdu, Chengdu 610066, Sichuan, China.
5. Department of Infectious Disease, Shaanxi Infectious Disease Hospital, Xi'an 610113, Shaanxi, China.
6. Department of Infectious Disease, Yulin Chinese Medicine Hospital, Yulin 719000, Shaanxi, China.
7. President's Office, The First Hospital of Qiqihar, Qiqihar 161005, Heilongjiang, China.
8. Department of Traditional Chinese Medicine, Shangluo Central Hospital, Shangluo 726000, Shaanxi, China.
9. Department of Traditional Chinese Medicine, The People's Hospital of Qitaihe, Qitaihe 154603, Heilongjiang, China.
10. Department of Scientific Research, Xianyang Central Hospital, Xianyang 712000, Shaanxi, China.
11. Department of traditional Chinese medicine, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230012, Anhui, China.
12. Department of Infectious Disease, Heping Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi, China.
13. Department of Traditional Chinese Medicine, Langfang Hospital of Chinese Medicine, Langfang 065000, Heibei, China.
14. Department of Traditional Chinese Medicine, Xingtai Hospital of Chinese Medicine, Xingtai 054001, Heibei, China.
15. Department of Traditional Chinese Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 168600, Guangxi, China.
16. Department of Traditional Chinese Medicine, The First People's Hospital of Fangchenggang, Fangchenggang 538001, Guangxi, China.
17. Department of Traditional Chinese Medicine, Mianyang Hospital of Traditional Chinese Medicine, Mianyang 621000, Sichuan, China.
18. Department of Traditional Chinese Medicine, Liuzhou People's Hospital, Liuzhou 545006, Gansu, China.
19. Department of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Nanyun 637000, Sichuan, China.
20. Department of Infectious Disease, Yan'an Second People's Hospital, Yan'an 716000, Shaanxi, China.
21. Department of Traditional Chinese Medicine, Dazhou Central Hospital, Dazhou 635000, Sichuan, China.
22. Chongqing Traditional Chinese Medicine Hospital, Chongqing 400011, China.
23. The Second People's Hospital of Neijiang, Neijiang 641000, Sichuan, China.
24. Shijiazhuang Fifth Hospital, Shijiazhuang 050021, Hebei, China.
25. Department of Infectious Disease, The Fourth People's Hospital of Taiyuan, Taiyuan 030053, Shanxi, China.
26. Department of Traditional Chinese Medicine, The First Hospital of Suihua City, Suihua 152053, Heilongjiang, China.
27. Department of Traditional Chinese Medicine, The Fourth People's Hospital of Nanning, Nanning 530023, Guangxi, China.
28. Department of Infectious Disease, Ankang Hospital of Traditional Chinese Medicine, Ankang 725000, Shaanxi, China.
29. Department of Infectious Disease, Beihai Hospital of Chinese Medicine, Beihai 536000, Guangxi, China.
30. Department of Infectious Disease, Harbin Infectious Disease Hospital, Harbin 150036, Heilongjiang, China.
31. Department of Infectious Disease, The Third People's Hospital of Linfen, Linfen 041000, Shanxi, China.
32. Department of Traditional Chinese Medicine, Chengde Hospital of Traditional Chinese Medicine, Chengde 067000, Hehei, China.
33. Department of Infectious Disease, Datong Fourth Hospital, Datong 037008, Shanxi, China.
34. Department of Traditional Chinese Medicine, Suining Central Hospital, Suining 629000, Sichuan, China.
35. Department of Infectious Disease, Jinzhong Infectious Disease Hospital, Jinzhong 030600, Shanxi, China.
36. Department of Infectious Disease, Jincheng People's Hospital, Jincheng 048026, Shanxi, China.
37. Hengshui Hospital of Chinese Medicine, Hengshui 053000, Heibei, China.
38. President's office, Hanzhong Central Hospital, Hanzhong 723000, Hubei, China.
39. Department of Infectious Disease, Shuozhou People's Hospital, Shuozhou 036002, Shanxi, China.
40. Department of Traditional Chinese Medicine, Mudanjiang Kangan Hospital, Mudanjiang 157011, Heilongjiang, China.
41. Department of Infectious Disease, Xinzhou People's Hospital, Xinzhou 034000, Shanxi, China.
42. Department of Infectious Disease, Daqing Second Hospital, Daqing 163000, Heilongjiang, China.
43. Department of Traditional Chinese Medicine,Jiamusi Infectious Disease Hospital, Jiamusi 154007, Heilongjiang, China.
44. Department of Infectious Disease, Yuncheng Second Hospital, Yuncheng 044000, Shanxi, China.
45. Department of Traditional Chinese Medicine, Hanzhong Hospital for Infectious Diseases, Hanzhong 723000, Hubei, China.
46. Department of medical administration, The Third People's Hospital of Yangquan, Yangquan 045000, Shanxi, China.
47. Department of Traditional Chinese Medicine, Zhangjiakou Hospital of Traditional Chinese Medicine, Zhangjiakou 075000, Hebei, China.
48. Department of Traditional Chinese Medicine, Baoji Central Hospital, Baoji 721000, Shaanxi, China.
49. Department of Infectious Disease, Xi'an Chest Hospital, Xi'an 710100, Shaanxi, China.
50. Department of Traditional Chinese Medicine, Hospital (T·C·M) Affiliated to Southwest Medical University, Luzhou 646000, Sichuan, China.
51. Department of Traditional Chinese Medicine, Qiqihar Institute for The Prevention and Treatment of Infectious Diseases, Qiqihar 161006, Heilongjiang, China.
52. Department of Traditional Chinese Medicine, Hegang Infectious Hospital, Hegang 154000, Heilongjiang, China.
53. Fenyang Hospital of Shanxi Province, Fenyang 032200, Shanxi, China.
54. Department of Infectious Disease, Shuangyashan People's Hospital, Shuangyashan 230502, Heilongjiang, China.
55. Department of Rehabilitation Medicine, The Affiliated Hospital of Putian College, Putian 351100, Fujian, China.
56. Department of Infectious Disease, The Greater Khingan Range People's Hospital, Great Khingan 165000, Heilongjiang, China.
57. Institute of Chinese Materia Medical, China
58. Academy of Chinese Medical Sciences, Beijing 100000, China.
Collective Name:'lung cleansing & detoxifying decoction' emergency project expert group for covid-19
Publication Type:Journal Article
Keywords: Age; COVID-19; Comorbidities; Gender; Severity; Treatment outcome
MeSH: Adult; Aged; COVID-19/virology*; China/epidemiology*; Comorbidity; Female; Humans; Male; Middle Aged; Retrospective Studies; Severity of Illness Index; Treatment Outcome
From: Biomedical and Environmental Sciences 2020;33(12):893-905
CountryChina
Language:English
Abstract: Objective:Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.
Methods:A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio (
Results:Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.
Conclusion:Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.