COVID-19 and comorbidities: Predictors, clinical course, relationship with disease severity, and outcome

Abstract

Aim: COVID-19 disease has a broad spectrum ranging from asymptomatic course to death. While data show that the prognosis of the disease will be poor in the presence of comorbidity, we witness the death of patients with no comorbidities in our clinical practice. This study aimed to investigate the effect of comorbidity on the clinical course and mortality of COVID-19 pneumonia.

Methods: 155 Rt-PCR (+) adult patients hospitalized at İzzet Baysal State Hospital (Bolu, Turkey) diagnosed with severe and critical pneumonia between August 2020 and February 2021 were included in this single-center, retrospective study. The patients were divided into two groups with and without comorbidity, compared the severity of inflammation parameters, radiological involvement, and oxygen requirement, and evaluated their effects on mortality and hospitalization duration.

Results:  There was no significant difference in the severity of the computed tomography (CT) involvement, the oxygen requirement, inflammation markers, and duration of hospitalization in patients with comorbidities compared to those without. When we evaluated the patients with comorbidities in general and their subgroups, the relationship with mortality was not significant. The severity of CT involvement, high oxygen requirement, and inflammation markers such as lymphocyte, lymphocyte ratio, LDH, CRP, troponin, ferritin levels were found to be associated with mortality.  

Conclusions:  In this study, we found that the presence of comorbidity did not affect mortality and duration of stay and that the severity of radiological involvement, the severity of hypoxemia, and the increase in inflammation markers were the determinants of mortality.