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Variable effects of underlying diseases on the prognosis of patients with COVID-19

 Yong Jun Choi  ;  Ju-Young Park  ;  Hye Sun Lee  ;  Jin Suh  ;  Jeung Yoon Song  ;  Min-Kwang Byun  ;  Jae Hwa Cho  ;  Hyung Jung Kim  ;  Hye Jung Park 
 PLOS ONE, Vol.16(7) : e0254258, 2021-07 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19 / epidemiology* ; COVID-19 / mortality ; Child ; Child, Preschool ; Comorbidity ; Diabetes Mellitus / epidemiology* ; Heart Failure / epidemiology* ; Humans ; Infant ; Kidney Diseases / epidemiology* ; Length of Stay / statistics & numerical data ; Middle Aged ; Mortality / trends ; Neoplasms / epidemiology* ; Pulmonary Disease, Chronic Obstructive / epidemiology* ; Survival Analysis
Underlying diseases might be risk factors for poor prognosis in patients with coronavirus disease (COVID-19); however, we still do not know whether these diseases are independent factors affecting prognosis, which type of underlying diseases are risk factors, and which type of clinical outcomes are affected. We retrospectively reviewed cohort data from 7,590 de-identified patients with COVID-19 who were diagnosed using severe acute respiratory syndrome-coronavirus-2 RNA polymerase chain reaction test up to May 15, 2020. We used linked-medical claims data provided by the Health Insurance Review and Assessment Service in South Korea. Underlying diseases were identified using the diagnostic codes in the patients' files from January 1, 2019 to December 31, 2019. The total mortality rate was 3.0% in patients with COVID-19. After adjusting for age, sex, and concomitant chronic conditions, we found that congestive heart failure, chronic pulmonary diseases, diabetes without chronic complications, renal diseases, and malignancy were factors that significantly increased the cost of treatment. Cerebrovascular disease, chronic pulmonary disease, and paralysis were found to be independent factors significant in prolonging hospital stay. Diabetes with chronic complications was independently associated with intensive care unit admission. In addition, underlying congestive heart failure (odds ratio [OR], 1.724; P = 0.003), dementia (OR, 1.598; P = 0.012), diabetes with and without chronic complications (OR, 1.821; P = 0.002 and OR, 1.518; P = 0.022, respectively), renal disease (OR, 2.299; P = 0.002), and malignancy (OR, 1.529; P = 0.039) were significant factors associated with death, even after adjustments. Underlying diseases were significant independent factors of the poor prognosis in patients with COVID-19. The effects were variable according to the type of underlying disease and clinical outcome. Therefore, patients with COVID-19 with underlying diseases should be monitored more closely because they are more at risk of a poor prognosis.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Hyung Jung(김형중) ORCID logo https://orcid.org/0000-0003-2498-0683
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Byun, Min Kwang(변민광) ORCID logo https://orcid.org/0000-0003-1525-1745
Suh, Jin(서진)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Cho, Jaehwa(조재화) ORCID logo https://orcid.org/0000-0002-3432-3997
Choi, Yong Jun(최용준) ORCID logo https://orcid.org/0000-0002-6114-2059
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