Comorbidities and outcomes among patients hospitalized with COVID-19 in Upper Egypt

  1. Eman M. Khedr
  2. Enas Daef
  3. Aliae Mohamed-Hussein
  4. Ehab F. Mostafa
  5. Mohamed Zein
  6. Sahar M. Hassany
  7. Hanan Galal
  8. Shimaa Abbas Hassan
  9. Islam Galal
  10. Amro A. Zarzour
  11. Hebatallah M. Hassan
  12. Mariam Taher Amin
  13. Maiada K. Hashem
  14. Khaled Osama
  15. Ayman Gamea

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Abstract

Background

The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 had consistently been reported as risk factors for unfavorable outcome. We aimed to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for intensive care unit (ICU) admission. Four hundred and thirty-nine adult patients who are admitted through (June and July 2020) in our 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.

Results

Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and lower respiratory tract (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 cardiovascular diseases (CVD) cases were admitted in ICU followed by diabetes mellitus (DM) cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 versus 10.7%, P  < 0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% versus 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).

Conclusions

Association of cardiovascular comorbid conditions including hypertension or neurological diseases including old cerebrovascular strokes 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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  1. Version published to 10.1186/s41983-022-00530-5
  2. ScreenIT

    SciScore for 10.1101/2020.11.28.20240267: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The weaknesses of advanced age are related to the function defense cells T and B, and to the excess production of type 2 cytokines, which can lead to a prolonged pro-inflammatory response, leading to unfortunate results(12). B) Common pathogenesis as chronic disorders collaborate several baseline topographies with communicable diseases, for instance the pro-inflammatory status, and the attenuation of the innate immune response. For instance, diabetes occurs in part because the accumulation of triggered innate immune cells leads to the release of inflammatory markers, principally IL-1β and Tumor necrosis factor α, that promote generalized resistance to insulin and destruction of β-cell (13). C) Immunity depletion by impairing macrophage and lymphocyte function which may make individuals more susceptible to infectious diseases and its complications(3). D) Up-regulation of angiotensin-converting enzyme 2 (ACE2) genes expression in different parts of the body, such as heart and lungs, in patients with diabetes, or CVD, increasing the susceptibility to SARS-CoV-2 infection and the risk of disease aggravation as it has been identified as an important functional receptor for SARS-CoV-2 invasion(4, 14). In the current study, cases with severe disease requiring ICU admission (35.8% compared to 16.4%), increased need for oxygen therapy, ventilatory support, and almost triple times death rate were significantly associated with patients recording comorbidities. However, by using univaria...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04459390RecruitingAssociation of Comorbidities With COVID19

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

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  3. Version published to 10.1101/2020.11.28.20240267v1 on medRxiv