Medical Comorbidities as Predictors of COVID-19 Short-Term Mortality: A
Historical Cohort Study
Abstract
Background: While the coronavirus disease 2019 (COVID-19) is most
commonly associated with the respiratory system, disorders in other
organ systems, such as the cardiovascular, neurologic, or renal, can
also contribute to disease fatality. This study aimed to evaluate the
relation of comorbidities to COVID-19 short-term mortality. Method: This
was a single-center observational study with a historical cohort method
at Bethesda Hospital Yogyakarta, Indonesia. COVID-19 diagnosis was made
by utilizing reverse transcriptase-polymerase chain reaction (RT-PCR) on
nasopharyngeal swabs. Patient data were retrieved from electronic
medical records and used for Charlson Comorbidity Index assessments.
In-hospital mortality was monitored throughout their hospital stay.
Results: This study enrolled 333 patients. According to the total number
of comorbidities in Charlson, 11.7% (n=39) of patients had no
comorbidities; 30.9% (n=103) of patients had one comorbidity; 20.1%
(n=67) of patients had two comorbidities; and 37.2% (n=124) of patients
had more than three comorbidities. In multivariate analysis, these
variables were significantly related to short-term mortality in COVID-19
patients: older age (odds ratio [OR] per year 1.64; 95% confidence
interval [CI] 1.23-2.19; p 0.001), myocardial infarction (OR 3.57 ;
95% CI 1.49-8.56; p: 0.004), diabetes mellitus (OR 2.41; 95 CI
1.17-4.97; p: 0.017), renal disease (OR 5.18 ; 95% CI 2.07-12.97; p
<0.001), and longer duration of stay (OR 1.20; 95% CI
1.08-1.32; p <0.001). Conclusion: Our study revealed multiple
risk factors for mortality in patients with COVID-19. The coexistence of
cardiovascular disease, diabetes, and renal problem are significant
predictors of short-term mortality in COVID-19 patients.