SIB #464 -Underlying Conditions in Severe COVID Disease.
The Study: Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021
Overview: This study reviewed records of 4,899,447 hospitalized adults (of which 11%/540,667 were diagnosed with COVID-19) for the purpose of better understanding the role of underlying conditions in severe cases of COVID-19.
Key Points:
· Records reviewed in this study were from patients hospitalized with COVID-19 between March 2020 and March 2021.
· The newer Delta variant was not a factor because of the time frames involved.
· 19 out of 20 (94.9%) of hospitalized COVID patients had at least 1 underlying medical condition
· The top five most common comorbidities associated with hospitalization following COVID infection were Hypertension, Disorders of Lipid Metabolism (Ex. Elevated Cholesterol/Triglycerides), Diabetes and Heart Disease.
· The strongest risk factors for death were Obesity, Anxiety/fear related disorders and Diabetes with complications.
· Relative risk of death was strongly correlated with the total number of underlying conditions.
· Patients with one underlying condition were 1.53 times while those with 10 or more conditions were 3.82 times as likely to die compared to patients with none.
· “Relative risk of death in the full model was 30% higher with obesity, 28% higher with anxiety and fear related disorders 26% higher with diabetes with complication…”
· “Age-stratified analysis showed that the number of frequent underlying medical conditions was higher with older age”
Author’s Conclusions: “The highest risk of severe COVID-19 illness was associated with obesity, anxiety and fear-related disorders, diabetes with complication, CKD, and neurocognitive disorders. Among patients younger than 40, essential hypertension was also a risk factor for death.” “Preventing COVID-19 in populations with these conditions and multiple conditions should remain a public health priority”
Reviewer's Comments: The authors state the percentage of the US adult population suffering with two or more underlying conditions ranges from 38-64% (according to state of residence) and yet, these already unhealthy patients make up 95% of hospitalizations and deaths from COVID-19. It is a sad fact that almost all of these most common co morbidities are diseases of lifestyle, many of which could be positively impacted quite quickly with simple changes in nutrition and exercise.
Reviewer: Mark R. Payne DC
Reference: : Kompaniyets L, Pennington AF, Goodman AB, Rosenblum HG, Belay B, Ko JY, et al. Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021. Prev Chronic Dis 2021;18:210123. DOI: http://dx.doi.org/10.5888/pcd18.210123 .
Link to Full Text: https://www.cdc.gov/pcd/issues/2021/21_0123.htm