Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Case Study Volume 3 Issue 12

Comorbid Risk Factors for an In-Hospital Fatal Outcome of Patients Hospitalized for Covid -19: A Case-control Study

Niculae Ion Nedelcu1, Magdalena George2 and David H Van Thiel2*

1Infectious and Tropical Diseases Hospital “Dr Victor Babes”, Bucharest, Romania
2Advanced Liver and Gastrointestinal Disease Center, Berwyn, USA

*Corresponding Author: David H Van Thiel, Advanced Liver and Gastrointestinal Disease Center, Berwyn, USA.

Received: November 02, 2020; Published: November 27, 2020

×

Abstract

  Between 13 March - 31 July 2020, 2,529 Covid-19 cases were discharged from the Victor Babes 490 bed hospital recognized by the government as the primary Covid-19 hospital in the capital, Bucharest. Eighty six of these 2,529 patients died in hospital for a case fatality rate (CFR) of 3.4 % (95% CI: 2.8 % - 4.2 %). The CFR for males was 4.7 % (54/1127) while in women it was 2.4 % (33/1402). The difference between these two rates is statistically significant [(Relative Risk (RR): 2.04; 95%CI: 1.33 - 3.12; p: 0.00083)]. Among the 86 who died, 11 (12.8%) were previously healthy (no reported under lying medical condition), 77 (87.2%) had at least one under lying medical condition, and 47 (54.7%) had two or more under lying medical conditions. The prevalence of each of the individual under lying medical conditions in these 86 patients was as follows: hypertension (68.6 %), diabetes mellitus (40.7%), obesity (33.7%), chronic kidney disease (27.9 %), and COPD (7.0 %). A 1:1 case control study was conducted after matching each case with one control of the same gender and age selected at random from the survivors list. Significant odds for death were identified for the presence of at least 2 under lying medical condition (OR:23.00; 95% CI (4.29 - 478.82);p: 0.0000), ), chronic kidney disease (OR: 9.00; 95% CI(2.41 - 57.41); p: 0.0008), and obesity (Odds Ratio (OR): 6.75; 95%CI (2.53 - 22.59); p: 0.0001). These data suggest that individuals with 2 or more under lying disease processes, and either chronic renal disease or obesity should be included in the list of individuals recommended for priority vaccination with a COVID-19 vaccine to reduce the likelihood of death should they become infected with COVID-19.

Keywords: COVID - 19; Hospital Cases; Fatality Rates; Case-control Study

×

References

  1. World Health Organization. Coronavirus disease (COVID‐19) Situation Report – 193.
  2. Garg S., et al. "Hospitalization rates and characteristics of patients hospitalized with laboratory‐confirmed coronavirus disease 2019—COVID‐NET, 14 states, March 1–30, 2020”. Morbidity and Mortality Weekly Report 69 (2020): 458‐464.
  3. Petrilli CM., et al. "Factors associated with hospitalization and critical illness among 4,103 patients with COVID‐19 disease in New York”. medRxiv (2020).
  4. Moula A I., et al. "Quantification of Death Risk in Relation to Sex, Pre-Existing Cardiovascular Diseases and Risk Factors in COVID-19 Patients: Let's Take Stock and See Where We Are”. Journal of Clinical Medicine9 (2020): E2685.
  5. Liu D., et al. "Risk factors for developing into critical COVID-19 patients in Wuhan, China: A multicenter, retrospective, cohort study”. EclinicalMedicine (2020).
  6. Muurlink O T and Taylor-Robinson A W. "COVID-19: Cultural Predictors of Gender Differences in Global Prevalence Patterns”. Frontiers in Public Health 8 (2020): 174.
  7. Lu L., et al. "A comparison of mortality-related risk factors of COVID-19, SARS, and MERS: A systematic review and meta-analysis”. Journal of Infection (2020): S0163-4453 (20)30460-6.
  8. Wang D., et al. "Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China”. Critical Care1 (2020): 188.
  9. Suleyman G., et al. "Clinical Characteristics and Morbidity Associated With Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit”. JAMA Netw Open6 (2020): e2012270.
  10. Fei Zhou., et al. "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study”. Lancet10229 (2020): 1054-1062.
  11. Porcheddu R., et al. "Similarity in Case Fatality Rates (CFR) of COVID- 19/SARS-COV-2 in Italy and China”. Journal of Infection in Developing Countries 14 (2020): 125-128.
  12. Cheng Y., et al. "Kidney disease is associated with in-hospital death of patients with COVID-19”. Kidney International5 (2020): 829-838.
  13. Hernandez-Galdamez D R., et al. "Increased Risk of Hospitalization and Death in Patients with COVID-19 and Pre-existing Noncommunicable Diseases and Modifiable Risk Factors in Mexico”. Archives of Medical Research 7 (2020): S0188-4409 (20)30722-0.
  14. Cai Q., et al. "Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China”. Diabetes Care7 (2020): 1392-1398.
  15. Klang E., et al. "Severe Obesity as an Independent Risk Factor for COVID-19 Mortality in Hospitalized Patients Younger than 50”. Obesity (Silver Spring)9 (2020): 1595-1599.
  16. Hussain A., et al. "Obesity and mortality of COVID-19. Meta-analysis’. Obesity Research and Clinical Practice 4 (2020): 295-300.
  17. Albashir A A D. "The potential impacts of obesity on COVID-19”. Clinical Medicne (Lond)4 (2020): e109-e113.
  18. Seidu S., et al. "The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis”. Endocrinology, Diabetes and Metabolism (2020): e00176.
  19. Rong-Hui Du., et al. "Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study”. European Respiratory Journal 5 (2020): 2000524.
  20. Chand S., et al. "COVID-19-Associated Critical Illness-Report of the First 300 Patients Admitted to Intensive Care Units at a New York City Medical Center”. Journal of Intensive Care Medicine10 (2020): 963-970.
  21. G M Parra-Bracamonte., et al. "Clinical characteristics and risk factors for mortality of patients with COVID-19 in a large dataset from Mexico”. Annuals of Epidemiology (2020): S1047-2797 (20)30286-6.
  22. Dietz W and Santos‐Burgoa C. "Obesity and its Implications for COVID‐19 Mortality”. Obesity 6 (2020): 1005.
  23. Yang J., et al. "Prevalence of comorbidities and its effects in patients infected with SARS‐CoV‐2: a systematic review and meta‐analysis”. International Journal of Infectious Diseases 94 (2020): 91-95.
  24. New York, NY: Department of Health (2020).
  25. Huang C., et al. "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet 10223 (2020): 497‐506.
  26. Chen G., et al. "Clinical and immunological features of severe and moderate coronavirus disease 2019”. Journal of Clinical Investigation5 (2020): 2620‐2629.
  27. Bornstein SR., et al. "Endocrine and metabolic link to coronavirus infection”. Nature Revivews Endocrinology6 (2020): 297‐298.
  28. Kruglikov IL and Scherer PE. "The role of adipocytes and adipocyte‐like cells in the severity of COVID‐19 infections”. Obesity7 (2020): 1187‐1190.
  29. Bourgeois C., et al. "Specific biological features of adipose tissue, and their impact on HIV persistence”. Frontiers in Microbiology 10 (2019): 2837.
  30. Darvall KAL., et al. "Obesity and thrombosis”. European Journal of Vascular and Endovascular Surgery 2 (2007): 223‐233.
  31. Lorenzet R., et al. "Thrombosis and obesity: cellular bases”. Thrombosis Research 3 (2012): 285‐289.
  32. Campello E., et al. "Hypercoagulability in overweight and obese subjects who are asymptomatic for thrombotic events”. Thrombosis and Haemostasis1 (2015): 85‐96.
×

Citation

Citation: David H Van Thiel., et al. “Comorbid Risk Factors for an In-Hospital Fatal Outcome of Patients Hospitalized for Covid -19: A Case-control Study". Acta Scientific Gastrointestinal Disorders 3.12 (2020): 24-27.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is April 30th, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US