key: cord-0817490-849p11cw
authors: Zádori, Noémi; Váncsa, Szilárd; Farkas, Nelli; Hegyi, Péter; Erőss, Bálint
title: The negative impact of comorbidities on the disease course of COVID-19
date: 2020-06-29
journal: Intensive Care Med
DOI: 10.1007/s00134-020-06161-9
sha: a462297155fd0dfb7a4e154cfc51d4f69c314bc1
doc_id: 817490
cord_uid: 849p11cw

nan

kidney disease (OR:5.3 CI 3.2-8.7), cardiovascular disease (OR:4.7, CI 2.9-7.6), cerebrovascular disease (OR:3.9, CI 1.8-8. 3 ), chronic obstructive pulmonary disease (OR:3.7, CI 2.7-5.1), hypertension (OR:2.7, CI 1.7-4.4), malignancy (OR:2.6, CI 1.5-4.3), diabetes (OR:2.5, CI 1.7-3.6) and immunodeficiency (OR:1.6, CI 1.0-2.5) were associated with increased risk of mortality. The analysis could not prove that Hepatitis B infection or chronic liver disease were associated with mortality due to the low number of participants with comorbidities ( Fig. 1 Patients with a history of cerebrovascular disease (OR:3.5, CI 1.9-6.5), chronic obstructive pulmonary disease (OR:2.2, CI 1.5-3.4), cardiovascular disease (OR:2.1, CI 1.5-3.0), hypertension (OR:1.9, CI 1.5-2.5), diabetes (OR:1.8, CI 1.3-2.5), malignancy (OR:1.7, CI 1.0-2.7) needed intensive care more often. The analysis could not prove that chronic liver disease, immunodeficiency, chronic kidney disease and hepatitis B infection were associated with higher admission rate to ICU (Supp. File 1. Results regarding severity are shown in Supplementary file 1, Fig. 3 . Reports on comorbidities not eligible for meta-analysis are summarized in Supplementary file 2, Table 6 .

In summary, cerebrovascular disease, chronic obstructive pulmonary disease, cardiovascular disease, hypertension, diabetes mellitus, malignancy are significant risk factors for poor clinical outcome in COVID-19. Our findings emphasize the critical role of comorbidities in the course of COVID-19. These results could be used for risk stratification of patients infected with SARS-CoV-2 and should be taken into consideration when establishing a prognostic tool. Although no specific treatment has 

World Health Organization

Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention

Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State

Risk factors of fatal outcome in hospitalized subjects with coronavirus disease 2019 from a nationwide analysis in China

Clinical characteristics of coronavirus disease 2019 in China