The role of essential organ-based comorbidities in the prognosis of COVID-19 infection patients

Abstract

Objectives: To assess the role of essential organ-based comorbidities in the prognosis of COVID-19 patients. Methods: All consecutive patients diagnosed with COVID-19 admitted to the Zhongnan Hospital of Wuhan University from 11 January to 16 March 2020 were enrolled in this retrospective cohort study.Results: A total of 212 COVID-19 patients were included. COVID-19 patients with heart, liver and kidneycomorbidity, compared to patients without related comorbidities, were more likely to have cardiac injuries [9.1%(3/33) vs 2.2%(4/179), P = 0.043], liver injuries [13.0%(3/23) vs 3.2%(6/189), P = 0.027], kidney injury [54.5%(6/11) vs 2.0%(4/201), P < 0.001], and higher risk of mortality [Heart-comorbidity: 6.1%(2/33) vs 0.6%(1/179), P = 0.014; Liver-comorbidity: 8.7%(2/23) vs 0.5%(1/189), P = 0.002; Kidney-comorbidity: 27.3%(3/11) vs 1.0%(2/201), P < 0.001. Mortality was higher in patients with more severe Grade of organ injuries [Heart-injury: P = 0.044; Liver-injury: P = 0.020; Kidney-injury: P = 0.030]. Conclusion: Male, older, co-existing of heart, liver, and kidney comorbidities, especially those with severe Grade organ injuries, had a poor prognosis after SARS-CoV-2 infection. ARTICLE HISTORY

Renal changes and acute kidney injury in covid-19: a systematic review

“…Cheng et al 19 emphasize that patients with a history of CKD exhibit a pro-inflammatory state with functional defects in innate and acquired immunity and are recognized as a population at greater risk for infections. However, this alone is not enough to explain the frequent occurrence of AKI in COVID-19 patients, and perhaps it only corroborates what was demonstrated by Yang et al 32 , who demonstrated that patients with kidney comorbidities are more susceptible to the development of AKI, although this does not apply exclusively to them. Pei et al 29 suggested that the severity of pneumonia was the main risk factor for the development of AKI in COVID-19 patients.…”

“…The pathogenesis of kidney injury in COVID- 19 has not yet been defined, but it has been observed that the presence of comorbidities can influence its development 32 . In this sense, Yang et al 32 have shown an incidence of kidney injury in patients with renal comorbidities significantly higher than in those without comorbidities (54.5% vs 2.0%, p<0.001). Cheng et al 19 found that out of all the patients with abnormalities in kidney function, 13% had an underlying kidney disease and 2% a history of chronic kidney disease (CKD).…”

“…In most studies, their values were measured at the time of patient admission ( Table 1) and varied based on the severity of the condition. Yang et al 32 found that 50% of the patients with AKI already had a high rate of serum creatinine at the time of admission. Patients with a normal rate of serum creatinine on admission had an increase in the second test, followed by a decrease in the glomerular filtration rate 32 .…”

Global impact of COVID-19 on non-communicable disease management: descriptive analysis of access to FRAX fracture risk online tool for prevention of osteoporotic fractures

“…The direct impact of SARS-CoV-2 infection and the COVID-19 pandemic on morbidity, mortality and healthcare resource use across the globe has rightly been the focus of much research. NCDs have also featured prominently given the interaction between underlying health conditions and the likelihood of adverse outcomes during the infection [11][12][13]. Perhaps less frequently, but no less importantly, some have drawn attention to the detrimental impact that the focus on COVID-19 will have on the medium to long term management and outcomes for many common NCDs [14][15][16][17].…”

A Risk Score to Predict Admission to the Intensive Care Unit in Patients with COVID-19: the ABC-GOALS score

“…respiratory rate and arterial pressure); 11,12 laboratory abnormalities including inflammatory, coagulation and organ-specific studies (e.g. lactate dehydrogenase, D-dimer, fibrinogen, cardiac troponins, liver function tests, among others), 5,6,[8][9][10]13 and lung imaging findings (e.g. number of affected lobes and estimated pneumonia extension).…”