Impact of Comorbidities on Prognosis in Asymptomatic, Mild, and Moderate COVID-19 Patients: A Retrospective Türkiye Study

INTRODUCTION: Predicting the mortality risk of 2019 coronavirus disease (COVID-19) patients in the early period is important in terms of using the limited health system’s resources efficiently. The aim of this study was to determine the effects of comorbidities on the occurrence of pneumonia and prognosis in asymptomatic, mild, and moderate COVID-19 patients.
METHODS: This retrospective, single-center, and cross-sectional study was conducted between April 1 and May 15, 2020, in the emergency department of a tertiary hospital in Istanbul, Türkiye. In our study, patients with laboratory-confirmed COVID-19 were examined for the occurrence of pneumonia and 28-day mortality.
RESULTS: The study was included 3047 adult patients. In our study, pneumonia detection rate was 55.3%, hospitalization rate was 18.0%, and 28-day mortality rate was 0.7%. NCIP (85.3% vs. 47.7%; p<0.001) and mortality (2.8% vs. 0.1%; p<0.001) rates were higher in patients with at least one comorbidity disease than those without. Advanced age, smoking, hypertension, diabetes, asthma, chronic kidney disease (CKD), and malignancy were important risk factors for the occurrence of pneumonia. In addition, in our study, COVID-19 patients with hypertension, diabetes, CKD, chronic liver disease, or malignancy had a higher probability of 28-day mortality.
DISCUSSION AND CONCLUSION: In our study, the most important risk factors for both pneumonia and 28-day mortality were advanced age, diabetes, CKD, and malignancy. The effects of comorbidities should be considered when determining the risk stratification and need for hospitalization of asymptomatic, mild, and moderate COVID-19 patients.