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Journal Article Epublish 6 citations

PubMed: 39170247 DOI: 10.1016/j.heliyon.2024.e35570

Unravelling the complex interplay of age, comorbidities, and multimorbidities in COVID-19 disease progression: Clinical implications and future perspectives.

Heliyon 10(15):e35570

Authors: Maria Shoukat, Haseeb Khan, Wajid Munir, Moona Nazish, Abdulwahed Fahad Alrefaei, Mohammed Fahad Albeshr, Anwar Ali, Saad Ahmed, Afsheen Mansoor, Massab Umair, Muhammad Suleman Rana, Malik Badshah

Affiliations

  • Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan. National Institute of Health, Islamabad, Pakistan.
  • Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.
  • Isolation Hospital and Infections Treatment Center, Islamabad, Pakistan.
  • Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan.
  • Department of Zoology, College of Science, King Saud University, P.O. Box 2455, Riyadh, 11451, Saudi Arabia.
  • University Hospital Kerry, Ritass, Tralee, Co. Kerry, Ireland.
  • Saidu Group of Teaching Hospitals, Swat, Pakistan.
  • Department of Dental Material Sciences, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
  • National Institute of Health, Islamabad, Pakistan.

Abstract

Introduction

The COVID-19 infection as an inflammatory disease has posed significant challenges to global public health due to multi-factor risks associated with it leading to disease severity and mortality. Understanding the effect of age and comorbidities on overall disease progression is crucial to identify highly susceptible individuals and to develop effective disease management strategies in a resource limited country like Pakistan.

Methodology

A retrospective study was conducted on hospitalized COVID-19 patients to assess the prevalence of various comorbidities among different age groups and their effect on disease severity and mortality rate.

Results

In this retrospective study, a cohort of 618 hospitalized COVID-19 patients was analyzed, consisting of 387 males (62.6 %) and 231 females (37.4 %). Notably, the young age group (15-24 years), had the lowest frequency of hospitalized COVID-19 patients, while no case was observed in children (≤14 years) showing a significant association (p < 0.001) of age and disease prevalence. Comorbidities were observed in 63.9 % of COVID-19 patients including hypertension (HTN), diabetes mellitus (DM), ischemic heart diseases (IHD), asthma, chronic kidney disease (CKD) and tuberculosis (TB). The most common comorbidities were HTN (42.1 %) followed by DM (33.8 %), IHD (16.5 %), asthma (11.2 %), CKD (7.9 %) and TB (1.9 %).Furthermore, the study revealed a significant association between comorbidities, age groups, and the need for non-invasive ventilation (NIV) (p < 0.001), mechanical ventilation (MV) (p < 0.001), and intensive care unit (ICU) admission (p < 0.001). Patients with specific comorbidities and those in the older age group (≥65 years) demonstrated a higher need for these interventions. However, patients without any comorbidity consistently exhibited the highest cumulative proportion of survival at each time point, indicating better overall survival outcomes. In contrast, patients with multimorbidities of DM/HTN/IHD, HTN/IHD, and DM/HTN/CKD had comparatively lower survival rates and higher mortality rates (p < 0.001).

Conclusion

This research highlights the significant impact of age, comorbidities and multimorbidities on the severity and mortality of COVID-19 patients. It highlights the importance of considering these factors in tailoring effective management strategies for patients with COVID-19 or other infectious respiratory diseases.

MeSH

Diabetes Mellitus, Comorbidity, Mortality, Retrospective Studies, Disease Progression, Multiple Chronic Conditions, Covid-19, Prevalence, Intensive Care Units, Asthma, Ventilation

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