1. Chronic diseases associated with increased likelihood of hospitalization and mortality in 68,913 COVID-19 confirmed cases in Spain: A population-based cohort study
- Author
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Gimeno-Miguel, A., Bliek-Bueno, K., Poblador-Plou, B., Carmona-Pírez, J., Poncel-Falcó, A., González-Rubio, F., Ioakeim-Skoufa, I., Pico-Soler, V., Aza-Pascual-Salcedo, M., Prados-Torres, A., Gimeno-Feliu, L.A., Moreno-Juste, A., Cano-Del-Pozo, M., Bandrés-Liso, A.C., Díez-Manglano, J., Ara-Bardají, P., and the PRECOVID Group
- Subjects
Male ,Viral Diseases ,Pulmonology ,Epidemiology ,Electronic Medical Records ,Urinary incontinence ,Comorbidity ,Cardiovascular Medicine ,Logistic regression ,Cohort Studies ,Pulmonary Disease, Chronic Obstructive ,Medical Conditions ,Endocrinology ,Risk Factors ,Medicine and Health Sciences ,Multidisciplinary ,Cancer Risk Factors ,Middle Aged ,Hospitals ,Hospitalization ,Infectious Diseases ,Oncology ,Cardiovascular Diseases ,Cohort ,Medicine ,Female ,medicine.symptom ,Information Technology ,Research Article ,Adult ,Computer and Information Sciences ,medicine.medical_specialty ,Endocrine Disorders ,Chronic Obstructive Pulmonary Disease ,Science ,Cardiology ,Respiratory Disorders ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,Aged ,business.industry ,SARS-CoV-2 ,COVID-19 ,Covid 19 ,Health Information Technology ,Odds ratio ,Cardiovascular Disease Risk ,medicine.disease ,Obesity ,Health Care ,Obstructive sleep apnea ,Logistic Models ,Health Care Facilities ,Spain ,Medical Risk Factors ,Metabolic Disorders ,Heart failure ,Respiratory Infections ,Chronic Disease ,business - Abstract
Background Clinical outcomes among COVID-19 patients vary greatly with age and underlying comorbidities. We aimed to determine the demographic and clinical factors, particularly baseline chronic conditions, associated with an increased risk of severity in COVID-19 patients from a population-based perspective and using data from electronic health records (EHR). Methods Retrospective, observational study in an open cohort analyzing all 68,913 individuals (mean age 44.4 years, 53.2% women) with SARS-CoV-2 infection between 15 June and 19 December 2020 using exhaustive electronic health registries. Patients were followed for 30 days from inclusion or until the date of death within that period. We performed multivariate logistic regression to analyze the association between each chronic disease and severe infection, based on hospitalization and all-cause mortality. Results 5885 (8.5%) individuals showed severe infection and old age was the most influencing factor. Congestive heart failure (odds ratio -OR- men: 1.28, OR women: 1.39), diabetes (1.37, 1.24), chronic renal failure (1.31, 1.22) and obesity (1.21, 1.26) increased the likelihood of severe infection in both sexes. Chronic skin ulcers (1.32), acute cerebrovascular disease (1.34), chronic obstructive pulmonary disease (1.21), urinary incontinence (1.17) and neoplasms (1.26) in men, and infertility (1.87), obstructive sleep apnea (1.43), hepatic steatosis (1.43), rheumatoid arthritis (1.39) and menstrual disorders (1.18) in women were also associated with more severe outcomes. Conclusions Age and specific cardiovascular and metabolic diseases increased the risk of severe SARS-CoV-2 infections in men and women, whereas the effects of certain comorbidities are sex specific. Future studies in different settings are encouraged to analyze which profiles of chronic patients are at higher risk of poor prognosis and should therefore be the targets of prevention and shielding strategies.
- Published
- 2021