Comorbidities and outcomes among patients hospitalized with COVID-19 in Upper Egypt

Eman M Khedr; Enas Daef; Aliae Mohamed-Hussein; Ehab F Mostafa; Mohamed Zein; Sahar M Hassany; Hanan Galal; Shimaa Abbas Hassan; Islam Galal; Amro A Zarzour; Hebatallah M Hassan; Mariam Taher Amin; Maiada K Hashem; Khaled Osama; Ayman Gamea

doi:10.1186/s41983-022-00530-5

Comorbidities and outcomes among patients hospitalized with COVID-19 in Upper Egypt

Egypt J Neurol Psychiatr Neurosurg. 2022;58(1):92. doi: 10.1186/s41983-022-00530-5. Epub 2022 Aug 12.

Authors

Eman M Khedr^{1

2

3}, Enas Daef⁴, Aliae Mohamed-Hussein⁵, Ehab F Mostafa⁶, Mohamed Zein⁷, Sahar M Hassany⁶, Hanan Galal⁸, Shimaa Abbas Hassan⁹, Islam Galal¹⁰, Amro A Zarzour⁹, Hebatallah M Hassan⁴, Mariam Taher Amin¹¹, Maiada K Hashem⁵, Khaled Osama¹, Ayman Gamea¹²

Affiliations

¹ Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt.
² Department of Neuropsychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt.
³ Neuropsychiatric Department, Faculty of Medicine, Aswan University Hospital, Aswan, Egypt.
⁴ Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁵ Department of Chest, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁶ Department of Tropical Medicine and Gastroenterology, Alrajhi University Hospital, Assiut University, Assiut, Egypt.
⁷ Department of Internal Medicine, Assiut University, Assiut, Egypt.
⁸ Clinical Pathology Labs, General Chest Hospital, Assiut, Egypt.
⁹ Department of Anesthesia and Intensive Care, Assiut University, Assiut, Egypt.
¹⁰ Department of Chest, Faculty of Medicine, Aswan University, Aswan, Egypt.
¹¹ Department of Public Health, Assiut University, Assiut, Egypt.
¹² Department of Neurology and Psychiatry, South Valley University, Qena, Egypt.

Abstract

Background: The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 had consistently been reported as risk factors for unfavorable outcome. We aimed to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for intensive care unit (ICU) admission. Four hundred and thirty-nine adult patients who are admitted through (June and July 2020) in our University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or probable case.

Results: Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and lower respiratory tract (LRT) symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of cardiovascular diseases (CVD) cases were admitted in ICU followed by diabetes mellitus (DM) cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 versus 10.7%, P < 0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% versus 81%, P < 0.001) and death rate was significantly higher in cases with comorbidities (P < 0.001) . The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P < 0.002 and 0.001, respectively).

Conclusions: Association of cardiovascular comorbid conditions including hypertension or neurological diseases including old cerebrovascular strokes together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.

Keywords: COVID-19; Cardiovascular diseases; Chronic pulmonary diseases; Comorbidities; Neurological diseases; Upper Egypt.