Features of comorbid pathology spectrum and age structure of oxygen-dependent patients with severe coronavirus disease 2019 (COVID-19) depending on outcomes of the disease

Authors

  • O. V. Riabokon Zaporizhzhia State Medical University, Ukraine, Ukraine
  • V. V. Cherkaskyi Municipal non-profit enterprise “Regional Infectious Diseases Clinical Hospital” of Zaporizhzhia Regional Council, Ukraine, Ukraine
  • T. Ye. Onishchenkо Zaporizhzhia State Medical University, Ukraine, Ukraine
  • Yu. Yu. Riabokon Zaporizhzhia State Medical University, Ukraine, Ukraine

DOI:

https://doi.org/10.14739/2310-1210.2021.2.228712

Keywords:

COVID-19, comorbidity

Abstract

The aim was to analyze spectrum of comorbid pathology and age structure of oxygen-dependent patients with severe coronavirus disease 2019 (COVID-19) depending on outcomes of the disease.

Materials and methods. The study included 85 oxygen-dependent patients with severe COVID-19. The patients were divided into groups: I – 70 patients with recovery; II – 15 patients in whom the disease was fatal. Statistical data processing was performed in the program Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J).

Results. Among the patients with fatal outcomes of the disease, elderly and senile were dominated – 93.3 % (14 of 15) versus 67.1 % (47 of 70) among patients who recovered (P < 0.05). Analysis of comorbid pathology structure in oxygen-dependent patients with severe COVID-19 showed that patients who died more often had hypertension (93.3 % vs. 30.0 %, P < 0.001), postinfarction cardiosclerosis (26.7 % vs. 2.9 %, P < 0.001), rhythm disturbance as persistent atrial fibrillation (20.0 % vs. 1.4 %, P < 0.01) as compared to those who survived. The patients of group II were more commonly diagnosed with chronic kidney disease (20.0 % vs. 4.3 %, P < 0.05) as the comorbid pathology. The presence of ischemic stroke in COVID-19 infection influenced the disease outcome (20.0 % vs. 4.3 %, P < 0.05). Fatal outcomes in the patients with COVID-19 were associated with a combination of 3 or more comorbid conditions in 46.7 % versus 17.4 % among oxygen-dependent survivors with severe disease (P < 0.01).

Conclusions. Elderly and senile oxygen-dependent patients are more likely to die from severe COVID-19 (P < 0.05). Comorbid hypertension, postinfarction cardiosclerosis, arrhythmia in the form of persistent atrial fibrillation, chronic kidney disease and ischemic stroke or the combination of 3 or more comorbid conditions listed are more common among patients with COVID-19 who died (P < 0.05) as compared to survivors.

Author Biographies

O. V. Riabokon, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Infectious Diseases

V. V. Cherkaskyi, Municipal non-profit enterprise “Regional Infectious Diseases Clinical Hospital” of Zaporizhzhia Regional Council, Ukraine

Head of the Department of Anesthesiology and Intensive Care

T. Ye. Onishchenkо, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the Department of Infectious Diseases

Yu. Yu. Riabokon, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Children Infectious Diseases

References

  1. Cui, J., Li, F., & Shi, Z. L. (2019). Origin and evolution of pathogenic coronaviruses. Nature Reviews Microbiology, 17(3), 181-192. https://doi.org/10.1038/s41579-018-0118-9
  2. Lu, R., Zhao, X., Li, J., Niu, P., Yang, B., Wu, H., Wang, W., Song, H., Huang, B., Zhu, N., Bi, Y., Ma, X., Zhan, F., Wang, L., Hu, T., Zhou, H., Hu, Z., Zhou, W., Zhao, L., Chen, J., … Tan, W. (2020). Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet, 395(10224), 565-574. https://doi.org/10.1016/S0140-6736(20)30251-8
  3. Andersen, K. G., Rambaut, A., Lipkin, W. I., Holmes, E. C., & Garry, R. F. (2020). The proximal origin of SARS-CoV-2. Nature Medicine, 26(4), 450-452. https://doi.org/10.1038/s41591-020-0820-9
  4. Wu, F., Zhao, S., Yu, B., Chen, Y. M., Wang, W., Song, Z. G., Hu, Y., Tao, Z. W., Tian, J. H., Pei, Y. Y., Yuan, M. L., Zhang, Y. L., Dai, F. H., Liu, Y., Wang, Q. M., Zheng, J. J., Xu, L., Holmes, E. C., & Zhang, Y. Z. (2020). A new coronavirus associated with human respiratory disease in China. Nature, 579(7798), 265-269. https://doi.org/10.1038/s41586-020-2008-3
  5. Wrapp, D., Wang, N., Corbett, K. S., Goldsmith, J. A., Hsieh, C. L., Abiona, O., Graham, B. S., & McLellan, J. S. (2020). Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science, 367(6483), 1260-1263. https://doi.org/10.1126/science.abb2507
  6. Turner, A. J., Hiscox, J. A., & Hooper, N. M. (2004). ACE2: from vasopeptidase to SARS virus receptor. Trends in Pharmacological Sciences, 25(6), 291-294. https://doi.org/10.1016/j.tips.2004.04.001
  7. Li, W., Moore, M. J., Vasilieva, N., Sui, J., Wong, S. K., Berne, M. A., Somasundaran, M., Sullivan, J. L., Luzuriaga, K., Greenough, T. C., Choe, H., & Farzan, M. (2003). Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature, 426(6965), 450-454. https://doi.org/10.1038/nature02145
  8. Yang, J. K., Lin, S. S., Ji, X. J., & Guo, L. M. (2010). Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetologica, 47(3), 193-199. https://doi.org/10.1007/s00592-009-0109-4
  9. Hoffmann, M., Kleine-Weber, H., Schroeder, S., Krüger, N., Herrler, T., Erichsen, S., Schiergens, T. S., Herrler, G., Wu, N. H., Nitsche, A., Müller, M. A., Drosten, C., & Pöhlmann, S. (2020). SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell, 181(2), 271-280.e8. https://doi.org/10.1016/j.cell.2020.02.052
  10. Tay, M. Z., Poh, C. M., Rénia, L., MacAry, P. A., & Ng, L. (2020). The trinity of COVID-19: immunity, inflammation and intervention. Nature Reviews Immunology, 20(6), 363-374. https://doi.org/10.1038/s41577-020-0311-8
  11. Connors, J. M., & Levy, J. H. (2020). Thromboinflammation and the hypercoagulability of COVID-19. Journal of Thrombosis and Haemostasis, 18(7), 1559-1561. https://doi.org/10.1111/jth.14849
  12. Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
  13. Grasselli, G., Zangrillo, A., Zanella, A., Antonelli, M., Cabrini, L., Castelli, A., Cereda, D., Coluccello, A., Foti, G., Fumagalli, R., Iotti, G., Latronico, N., Lorini, L., Merler, S., Natalini, G., Piatti, A., Ranieri, M. V., Scandroglio, A. M., Storti, E., Cecconi, M., … COVID-19 Lombardy ICU Network. (2020). Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA, 323(16), 1574-1581. https://doi.org/10.1001/jama.2020.5394
  14. Goyal, P., Choi, J. J., Pinheiro, L. C., Schenck, E. J., Chen, R., Jabri, A., Satlin, M. J., Campion, T. R., Jr, Nahid, M., Ringel, J. B., Hoffman, K. L., Alshak, M. N., Li, H. A., Wehmeyer, G. T., Rajan, M., Reshetnyak, E., Hupert, N., Horn, E. M., Martinez, F. J., Gulick, R. M., … Safford, M. M. (2020). Clinical Characteristics of Covid-19 in New York City. The New England Journal of Medicine, 382(24), 2372-2374. https://doi.org/10.1056/NEJMc2010419
  15. Cai, Q., Chen, F., Wang, T., Luo, F., Liu, X., Wu, Q., He, Q., Wang, Z., Liu, Y., Liu, L., Chen, J., & Xu, L. (2020). Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China. Diabetes Care, 43(7), 1392-1398. https://doi.org/10.2337/dc20-0576
  16. Guo, T., Fan, Y., Chen, M., Wu, X., Zhang, L., He, T., Wang, H., Wan, J., Wang, X., & Lu, Z. (2020). Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiology, 5(7), 811-818. https://doi.org/10.1001/jamacardio.2020.1017
  17. Deng, Q., Hu, B., Zhang, Y., Wang, H., Zhou, X., Hu, W., Cheng, Y., Yan, J., Ping, H., & Zhou, Q. (2020). Suspected myocardial injury in patients with COVID-19: Evidence from front-line clinical observation in Wuhan, China. International Journal of Cardiology, 311, 116-121. https://doi.org/10.1016/j.ijcard.2020.03.087
  18. Nishiga, M., Wang, D. W., Han, Y., Lewis, D. B., & Wu, J. C. (2020). COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nature Reviews Cardiology, 17(9), 543-558. https://doi.org/10.1038/s41569-020-0413-9
  19. Shi, S., Qin, M., Shen, B., Cai, Y., Liu, T., Yang, F., Gong, W., Liu, X., Liang, J., Zhao, Q., Huang, H., Yang, B., & Huang, C. (2020). Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiology, 5(7), 802-810. https://doi.org/10.1001/jamacardio.2020.0950
  20. Oyelade, T., Alqahtani, J., & Canciani, G. (2020). Prognosis of COVID-19 in Patients with Liver and Kidney Diseases: An Early Systematic Review and Meta-Analysis. Tropical Medicine and Infectious Disease, 5(2), Article 80. https://doi.org/10.3390/tropicalmed5020080
  21. Arentz, M., Yim, E., Klaff, L., Lokhandwala, S., Riedo, F. X., Chong, M., & Lee, M. (2020). Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. JAMA, 323(16), 1612-1614. https://doi.org/10.1001/jama.2020.4326

Downloads

Published

2021-04-16

How to Cite

1.
Riabokon OV, Cherkaskyi VV, Onishchenkо TY, Riabokon YY. Features of comorbid pathology spectrum and age structure of oxygen-dependent patients with severe coronavirus disease 2019 (COVID-19) depending on outcomes of the disease. Zaporozhye Medical Journal [Internet]. 2021Apr.16 [cited 2026May13];23(2):214-9. Available from: https://zmj.zsmu.edu.ua/article/view/228712

Issue

Section

Original research