Impact of comorbidity burden on mortality in patients with COVID-19: a retrospective analysis of the Korean health insurance database

Abstract

We aimed to investigate the impact of comorbidity burden on mortality in patients with COVID-19. We analyzed the COVID-19 data from the nationwide health insurance claims of South Korea. Data on demographic characteristics, comorbidities, and mortality records of patients with COVID-19 were extracted from the database. The odds ratios of mortality according to comorbidities in patients with COVID-19 with and without adjustment for age and sex were calculated. The predictive value of the original Charlson comorbidity index (CCI) and the age-adjusted CCI (ACCI) for mortality in patients with COVID-19 were investigated using the receiver operating characteristic (ROC) curve analysis. Among 7,590 patients with COVID-19, 227 (3.0%) had died. After age and sex adjustment, hypertension, diabetes mellitus, congestive heart failure, dementia, chronic pulmonary disease, liver, renal, and cancer were significant risk factors for mortality. The ROC curve analysis showed that ACCI threshold ≥4 yielded the best cut-off point for predicting mortality (area under the ROC 0.92; 95% CI, 0.91–0.94). Our study revealed multiple risk factors that were associated with mortality in patients with COVID-19. The high predictive power of the ACCI for mortality in our results could support the importance of old age and comorbidities in the severity of COVID-19.

Comorbidity and Its Impact on Mortality of COVID-19 in Yazd Province, a Central part of Iran: a Hospital-based study

“…Chronic liver disease, which elevates the risk of death of people with the virus, can also be one of the determinant factors of the final outcome of patients with COVID-19. Several studieshavealso shown thatpeople with liver diseaseare more vulnerable so that liver disease increases the odds of death in contaminated cases (8,16,17).…”

“…Co-occurrence of non-communicable diseases such as diabetes, cardiovascular disease, cancer, hypertension, kidney disease, and other chronic diseases is taken as a proven risk factor for increasing risk of acute outcome or even death from COVID-19 (6,7).Treatment of COVID-19 in patients with underlying co-morbidity may be associated with intensive cares and ventilator supports (4).Identifying risk factors for mortality is an important component for COVID-19 management strategies. These evidences are important at a time when demand for intensive care is increasing and resources are limited (8)(9)(10).…”

COVID-19 and mortality risk in patients with psychiatric disorders

“…Later, it was shown that people from more deprived social backgrounds and those belonging to ethnic minorities were also at an increased risk. Preexisting medical conditions, such as congestive heart failure, dementia, chronic pulmonary disease, liver or renal disease, and cancer have also been shown to increase the risk (e.g., Cho et al, 2021).…”