Association of Comorbidities & Disease Outcome in COVID-19 Patients in A tertiary Care Medical College in India

Document Type : Original Article

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Department of Medicine, Ruxmaniben Deepchand Gardi Medical College [RDGMC], Ujjain, India

Abstract

Background: Severe acute respiratory syndrome corona virus-2 [SARS CoV2], the virus that cause the COVID-19 pandemic remained a persistent challenge worldwide. India emerged as the second most affected nation after the United States. Many previous studies confirmed the association of comorbidities like diabetes, hypertension, etc. as associated with adverse outcomes in COVID-19.
Aim of the work: The current study aimed to ascertain the association of comorbidities like diabetes, hypertension, and CAD with adverse disease outcomes in COVID-19 pneumonia.
Patients and Methods: A retrospective observational study was conducted with the data retrieved from medical records of patients admitted with a reverse transcription-polymerase chain reaction [RT-PCR] positive COVID-19 in the intensive care unit [ICU] of a tertiary medical college. We analyzed 467 RT-PCR confirmed COVID19 cases with respect to the association with adverse and critical disease states. Criticality was defined as any one of: a] use of ventilation, b] death or c] Radiographic assessment of lung edema [RALE] Score >24.
Results: Of the total cases among critical cases, 52% [95% CI 46%-59%] has comorbidity and non-critical cases 41% had comorbidity [95% CI 34%-48%]. The prevalence of diabetes among critical cases was 43% [95% CI 37%-49%] while in non-critical cases it was 28% [95%CI 21%-34%]. Hypertension was prevalent in 30% [95% CI 24%-37%] in non-critical cases while it was prevalent in 33 % [95% CI 27%-38%] in critical cases. We also examined the association of comorbidities in the ICU admitted cohort and found that there is a significant association of diabetes [p-<0.01] and hypertension [p-<0.01], Obesity [p<0.05], and CAD [p<0.05] with adverse disease outcome.
Conclusion: Three most common comorbidities, diabetes, hypertension, and obesity have statistically significant associations with adverse outcomes in COVID 19. There was also a statistically significant association seen with CAD, probably due to the thrombogenic potential of COVID-19. 

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