Noncommunicable disease, clinical course and COVID-19 prognosis: results based on I-CORE Registry

Abstract

Background: There are no data on the association between clinical course and comorbidity in Iranian patients with COVID-19. Aims: To determine noncommunicable disease (NCD), clinical characteristics and prognosis of patients hospitalized with COVID-19 in Isfahan, Islamic Republic of Iran. Methods: This multicentric retrospective observational study was performed on all patients hospitalized with COVID-19 in Isfahan from 17 February to 6 April 2020. We recruited 5055 patients. Data on clinical course and comorbid NCDs such as hypertension, coronary heart disease (CHD), diabetes mellitus (DM), cancer, chronic kidney disease (CKD) and chronic respiratory disease (CRD) were collected. Statistical analyses were done by Mann-Whitney U, chi(2) and logistic regression tests using Stata version 14. Results: DM and hypertension were the most prevalent comorbidities in patients with positive and negative reverse transcription polymerase chain reaction (RT-PCR). Odds ratio (95 confidence interval) of mortality-associated factors was significant for DM 1.35 (1.07-1.70), CHD 1.58 (1.26-1.96), CRD 2.18 (1.58-3.0), and cancer 3.55 (2.42-5.21). These results remained significant for cancer after adjustment for age, sex and clinical factors. Among patients with positive RT-PCR, death was significantly associated with CRD and cancer, while this association disappeared after adjustment for all potential confounders. There was a significant association between NCDs and higher occurrence of low oxygen saturation, mechanical ventilation requirement and intensive care unit admission after adjustment for age and sex. Conclusion: The presence of NCDs alone did not increase mortality in patients with COVID-19, after adjustment for all potential confounders including clinical factors.