Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study
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Objectives: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. Methods: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. Results: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. Conclusions: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico. Key words: Comorbidity, COVID-19, Multimorbidity, Severe acute respiratory syndrome coronavirus
Abstract
Objectives: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. Methods: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. Results: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. Conclusions: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico. Key words: Comorbidity, COVID-19, Multimorbidity, Severe acute respiratory syndrome coronavirus
참고문헌 (35)
- "Maps & trends"[URL]
- Wang D, "Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China", JAMA, 323(11), pp.1061~1069 (2020)
- Huang C, "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China", Lancet, 395(10223), pp.497~506 (2020)
- Fang L, "Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection", Lancet Respir Med, 8(4), pp.e21~ (2020)
- Varga Z, "Endothelial cell infection and endotheliitis in COVID-19", Lancet, 395(10234), pp.1417~1418 (2020)
- "Noncommunicable diseases (NCD) country profiles 2018"[URL]
- Nonato IC, "Hypertension in Mexican adults: prevalence, diagnosis and type of treatment. Ensanut MC 2016", Salud Publica Mex, 60(3), pp.233~243 (2018)
- Guan WJ, "Comorbidity and its impact on 1590 patients with COVID-19 in China : a nationwide analysis", Eur Respir J, 55(5), pp.2000547~ (2020)
- Henry BM, "Chronic kidney disease is associated with severe coronavirus disease 2019(COVID-19)infection", Int Urol Nephrol, 52(6), pp.1193~1194 (2020)
- Boettler T, "Care of patients with liver disease during the COVID-19 pandemic : EASL-ESCMID position paper", JHEP Rep, 2(3), pp.100113~ (2020)
- Zhou F, "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China : a retrospective cohort study", Lancet, 395(10229), pp.1054~1062 (2020)
- Shi Y, "Host susceptibility to severe COVID-19 and establishment of a host risk score : findings of 487 cases outside Wuhan", Crit Care, 24(1), pp.108~ (2020)
- Yang J, "Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2 : a systematic review and meta-analysis", Int J Infect Dis, 94, pp.91~95 (2020)
- Chen T, "Clinical characteristics of 113 deceased patients with coronavirus disease 2019 : retrospective study", BMJ, 368, pp.m1091~ (2020)
- "Coronavirus disease 2019 (COVID-19)"[URL]
- Sun ML, "Inhibitors of RAS might be a good choice for the therapy of COVID-19 pneumonia", Zhonghua Jie He He Hu Xi Za Zhi, 43(3), pp.219~222 (2020)
- Diaz JH, "Hypothesis : angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19", J Travel Med, 27(3), pp.taaa041~ (2020)
- Bravi F, "Predictors of severe or lethal COVID-19, including angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, in a sample of infected Italian citizens", PLoS One, 15(6), pp.e0235248~ (2020)
- Mo P, "Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China", Clin Infect Dis, pp.ciaa270~ (2020)
- Yang X, "Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study", Lancet Respir Med, 8(5), pp.475~481 (2020)
- Wu C, "Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China", JAMA Intern Med, pp.e200994~ (2020)
- Li K, "The clinical and chest CT features associated with severe and critical COVID-19 pneumonia", Invest Radiol, 55(6), pp.327~331 (2020)
- Liu W, "Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease", Chin Med J(Engl), 133(9), pp.1032~1038 (2020)
- Arokiasamy P, "The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal?", BMC Med, 13, pp.178~ (2015)
- Patel AB, "COVID-19 and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: what is the evidence?", JAMA, 323(18), pp.1769~1770 (2020)
- Guan WJ, "Clinical characteristics of coronavirus disease 2019 in China", N Engl J Med, 382(18), pp.1708~1720 (2020)
- Dietz W, "Obesity and its implications for COVID-19 mortality", Obesity(Silver Spring), 28(6), pp.1005~ (2020)
- Ryan DH, "COVID 19 and the patient with obesity-the editors speak out", Obesity(Silver Spring), 28(5), pp.847~ (2020)
- D’Antiga L, "Coronaviruses and immunosuppressed patients : the facts during the third epidemic", Liver Transpl, 26(6), pp.832~834 (2020)
- Siddiqi HK, "COVID-19 illness in native and immunosuppressed states : a clinical-therapeutic staging proposal", J Heart Lung Transplant, 39(5), pp.405~407 (2020)
- Lippi G, "Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019(COVID-19)", Respir Med, 167, pp.105941~ (2020)
- Cheng Y, "Kidney disease is associated with in-hospital death of patients with COVID-19", Kidney Int, 97(5), pp.829~838 (2020)
- Nunes BP, "Multimorbidity and mortality in older adults : a systematic review and meta-analysis", Arch Gerontol Geriatr, 67, pp.130~138 (2016)
- Landi F, "Disability, more than multimorbidity, was predictive of mortality among older persons aged 80 years and older", J Clin Epidemiol, 63(7), pp.752~759 (2010)
- Rivera-Almaraz A, "Disability, quality of life and all-cause mortality in older Mexican adults: association with multimorbidity and frailty", BMC Geriatr, 18(1), pp.236~ (2018)