Impact of comorbidities on the severity of illness of COVID-19 patients managed in a Southern Nigerian State

Abstract

Background: Coronavirus disease 2019 (COVID-19) is characterized by varying clinical manifestations ranging from asymptomatic disease, mild upper respiratory illness, severe pneumonia and acute respiratory distress syndrome. Patients with COVID-19 who have comorbidities are at risk of having a more severe disease course, longer duration of hospitalization, complications and need for intensive care. The pattern of comorbidities in patients with COVID-19 in Nigeria has not been adequately described yet.
Objective: This study aimed to access the actual burden of comorbidities and their impact on the severity of COVID-19.
Materials and Methods: This was a retrospective cohort study of patients with confirmed COVID-19 using reverse transcription polymerase chain reaction. All confirmed COVID-19 patients diagnosed in Akwa Ibom State from April 1, 2020 to September 30, 2020 and admitted in the isolation facilities were enrolled into this study. A proforma was used to obtain the sociodemographic characteristics of the patient, the type(s) of comorbidity and the severity class. Data was analyzed using SPSS 23.
Results: One hundred and forty-nine patients were included in this study. The most common comorbidities were hypertension (32.2%) and diabetes mellitus (19.5%). Severe or critical disease was significantly found in 17 (35.4%) of the patients with hypertension and 15 (51.7%) of the patients with diabetes with p-value <0.01 on univariate analysis. After multivariate logistic regression, having diabetes mellitus (OR: 4.48, 95% CI: 1.37 – 14.70) and age (OR: 1.07, 95% CI: 1.02 – 1.13) were independent predictors of severity in COVID-19 patients with p-value <0.01. Conclusion: The presence of comorbidities is associated with worsening clinical outcomes in patients with SARS-CoV-2 infection. There is therefore need for closer monitoring of COVID-19 patients having comorbid conditions.