Yan Ma1, Dong Shan Zhu2, Ren Bo Chen1, Nan Nan Shi1, Si Hong Liu3, Yi Pin Fan1, Gui Hui Wu4, Pu Ye Yang5, Jiang Feng Bai6, Hong Chen7, Li Ying Chen8, Qiao Feng9, Tuan Mao Guo10, Yong Hou11, Gui Fen Hu12, Xiao Mei Hu13, Yun Hong Hu14, Jin Huang15, Qiu Hua Huang15, Shao Zhen Huang16, Liang Ji17, Hai Hao Jin18, Xiao Lei19, Chun Yan Li20, Min Qing Li21, Qun Tang Li22, Xian Yong Li23, Hong De Liu24, Jin Ping Liu25, Zhang Liu26, Yu Ting Ma27, Ya Mao28, Liu Fen Mo29, Hui Na30, Jing Wei Wang30, Fang Li Song31, Sheng Sun32, Dong Ting Wang33, Ming Xuan Wang34, Xiao Yan Wang35, Yin Zhen Wang36, Yu Dong Wang37, Wei Wu38, Lan Ping Wu39, Yan Hua Xiao40, Hai Jun Xie41, Hong Ming Xu42, Shou Fang Xu43, Rui Xia Xue44, Chun Yang45, Kai Jun Yang46, Sheng Li Yuan47, Gong Qi Zhang48, Jin Bo Zhang49, Lin Song Zhang50, Shu Sen Zhao51, Wan Ying Zhao52, Kai Zheng53, Ying Chun Zhou54, Jun Teng Zhu55, Tian Qing Zhu56, Hua Min Zhang57, Yan Ping Wang1, Yong Yan Wang1. 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; Academy of Chinese Medical Sciences, Beijing 100000, China.
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 ( OR) and 95% confidence interval (95% CI) of the associations between comorbidities (cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19. 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.
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 ( OR) and 95% confidence interval (95% CI) of the associations between comorbidities (cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19. 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.
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