The Effect of Comorbidities and Complications on COVID-19 Mortality: A Detailed Retrospective Study in Western Romania.
Monica Steluța MarcDaniela RoscaFelix BratosinOvidiu Fira-MladinescuCristian Iulian OanceaPescaru Camelia CorinaDiana Raluca VelescuNorbert WellmannAlexandru Catalin MotofeleaIoana Mihaiela CiucaKarina SaracinDiana Luminita ManolescuPublished in: Journal of personalized medicine (2023)
COVID-19 continues to impact global health systems even after being declared over, with some patients exhibiting severe complications linked to pre-existing conditions. This study aimed to investigate the association between comorbidities, complications, and survival outcomes among COVID-19 survivors in Western Romania. Our hypothesis posited that comorbidities and complications significantly influence survival rates. We conducted a retrospective analysis of 1948 COVID-19 survivors admitted from January to December 2021, with 192 selected for detailed analysis based on inclusion and exclusion criteria. The severity of COVID-19 was classified according to WHO guidelines, and conditions like hypertension and obesity were defined using criteria from the European Society of Hypertension (ESH), the European Society of Cardiology (ESC), and WHO, respectively. Among the 192 patients, 33 had mild, 62 had moderate, and 97 had severe COVID-19. The median age across the severity groups was 63.2 years. Patients undergoing tracheostomy had a mortality rate of 83.3% versus 22.2% for non-tracheostomy patients ( p < 0.001) and presented with significantly higher lung injury, hospitalization duration, and complications. Remarkably, tracheostomized patients were 17.50 times more likely to succumb to the disease (95% CI 4.39-116.91, p < 0.001). Furthermore, pneumothorax increased the mortality risk significantly (OR 22.11, 95% CI 5.72-146.03, p < 0.001). Intriguingly, certain conditions like grade I hypertension and grade II obesity showed a protective effect against mortality, whereas type 2 diabetes mellitus increased mortality risk (univariate OR 2.89, p = 0.001). The presence of certain comorbidities and complications significantly impacts the survival rates of COVID-19 patients in Western Romania. Notably, tracheostomy, pneumothorax, and T2DM were associated with increased mortality. This study underscores the importance of personalized patient care and provides insights for healthcare policymakers in Western Romania to improve clinical management strategies.
Keyphrases
- end stage renal disease
- sars cov
- coronavirus disease
- chronic kidney disease
- risk factors
- newly diagnosed
- blood pressure
- ejection fraction
- patients undergoing
- prognostic factors
- type diabetes
- peritoneal dialysis
- cardiovascular events
- metabolic syndrome
- weight loss
- intensive care unit
- cardiovascular disease
- cardiac surgery
- physical activity
- body mass index
- early onset
- social media
- acute kidney injury
- glycemic control
- extracorporeal membrane oxygenation
- thoracic surgery