Background: Since the onset of the novel coronavirus (COVID-19) pandemic, ongoing research exploring risk factors and adverse outcomes in COVID-19 patients has been conducted. This study examined common comorbidities observed in patients diagnosed with COVID-19 and admitted to St. Catherine of Siena Medical Center in Smithtown, N.Y. The impact of these comorbidities on level of care (standard hospital admission or ICU admission) and mortality were determined. Furthermore, the effects of age, gender, ethnicity, BMI, smoking history, and number of comorbidities on these outcomes was described.
Methods: A cross-sectional study was performed utilizing data from confirmed COVID-19 cases recorded between 3/8/20 to 4/29/20 at St. Catherine of Siena Medical Center. The data for this study was gathered from EPIC Systems electronic medical record. Comorbidities were selected based on nine CDC reported conditions in adults that increase risk of severe illness in COVID-19 patients and were categorized and verified by two researchers. Data analysis was performed in IBM SPSS Statistics and included prevalence, chi square, binomial logistic regression, and Cox regression.
Results: The study consisted of 537 patients, 53.4% males (N=287) and 46.4% females (N=249). Of the patients in this group, 21.4% (N=115) identified as Hispanic or Latino and 77.3% (N=415) identified as non-Hispanic or Latino. The mean age of patients was 69 years old and the mean number of comorbidities per patient was 1.94 (SD=1.60). The most common comorbidities recorded were hypertension (41.34%), cardiovascular disease (34.08%), overweight/obesity (32.96%). One binomial logistic regression model examining mortality (X2 (6, N=537) = 60.29, p<3.94e-11)) revealed statistically significant relationships associated with age (p=1.97e-7), gender (p=1.08e-2), BMI (p=3.67e-3), and number of comorbidities (p=3.10e-2). Chi-square analysis specifically revealed associations between cardiovascular disease (p=1.25e-8), chronic obstructive pulmonary disease (p= 2.61e-5), and chronic kidney disease (p=3.13e-7) on mortality. The second binomial logistic regression model examining level of care (X2 (6, N=537) = 17.45, p<7.75e-3) revealed statistically significant relationships between gender (p=3.56e-2) and number of comorbidities (p=4.17e-3). Chi-square analysis specifically revealed associations between cardiovascular disease (p=3.99e-3) and diabetes mellitus (p=7.42e-3) on level of care.
Conclusions: This study determined that male gender along with increased age, BMI, and number of comorbidities were associated with higher mortality due to COVID-19 infection. Additionally, male gender and increased number of comorbidities were associated with higher level of care requirements by means of ICU admission. Specific comorbidities, including CVD, COPD, and CKD were significantly associated with mortality while CVD and DM were significantly associated with level of care requirements. The implications of these findings evidence the detrimental effects of underlying conditions on patients infected with COVID-19 and assists in identification of patients who are at risk of severe illness.
