Poorer Clinical Outcomes in COVID-19 Driven by Comorbidities

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In laboratory-confirmed cases of COVID-19, patients with any comorbidities have experienced poorer clinical outcomes compared with those without comorbidities.

In laboratory-confirmed cases of coronavirus disease 2019 (COVID-19), patients with any comorbidities experienced poorer clinical outcomes than those without, according to the results of a retrospective case study published in the European Respiratory Journal.

According to the latest reports, the clinical manifestations of COVID-19 are heterogeneous, with 20% to 51% of patients reported as having ≥1 comorbidity on hospital admission, with diabetes (10%-20%), hypertension (10%-15%), and other cardiovascular and cerebrovascular diseases (7%-40%) being the most common. COVID-19 results in respiratory failure and death in susceptible patients, and studies are needed to explore the factors underlying the adverse impact of COVID-19.

Researchers analyzed data from 1590 patients with laboratory-confirmed COVID-19 who were hospitalized across mainland China between December 11, 2019, and January 31, 2020 to evaluate the risk for serious adverse outcomes in these patients by stratifying the comorbidity status. They found that 16% of the study population were severe cases, with 131 (8.2%) of patients reaching the composite end points of admission to an intensive care unit, invasive ventilation, or death.

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A total of 399 (25.1%) reported having ≥1 comorbidity, while 130 (8.2%) were reported as having ≥2 comorbidities. Hypertension was reported in 16.9% of patients, diabetes in 8.2% of patients, and other cardiovascular diseases in 53.7% of patients. After adjusting for age and smoking status, patients with chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and malignancy were more likely to reach the composite end points.

“Among laboratory-confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without,” the researchers concluded. “A greater number of comorbidities also correlated with poorer clinical outcomes.” A thorough assessment of comorbidities may help establish risk stratification of patients with COVID-19 upon hospital admission.


Guan W-j, Liang W-h, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis [published online March 26, 2020]. Eur Respir J. doi:10.1183/13993003.00547-2020

This article originally appeared on Pulmonology Advisor