Comorbidity status of deceased COVID-19 in-patients in Italy

Aging Clin Exp Res. 2021 Aug;33(8):2361-2365. doi: 10.1007/s40520-021-01914-y. Epub 2021 Jun 24.

Abstract

Background: Most COVID-19-related deaths have occurred in older persons with comorbidities. Specific patterns of comorbidities related to COVID-19 deaths have not been investigated.

Methods: A random sample of 6085 individuals in Italy who died in-hospital with confirmed COVID-19 between February and December 2020 were included. Observed to expected (O/E) ratios of disease pairs were computed and logistic regression models were used to determine the association between disease pairs with O/E values ≥ 1.5.

Results: Six pairs of diseases exhibited O/E values ≥ 1.5 and statistically significant higher odds of co-occurrence in the crude and adjusted analyses: (1) ischemic heart disease and atrial fibrillation, (2) atrial fibrillation and heart failure, (3) atrial fibrillation and stroke, (4) heart failure and COPD, (5) stroke and dementia, and (6) type 2 diabetes and obesity.

Conclusion: In those deceased in-hospital due to COVID-19 in Italy, disease combinations defined by multiple cardio-respiratory, metabolic, and neuropsychiatric diseases occur more frequently than expected. This finding indicates a need to investigate the possible role of these clinical profiles in the chain of events that lead to death in individuals who have contracted SARS-CoV-2.

Keywords: COVID-19; Chronic disease; Comorbidity; Mortality; Multimorbidity.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19*
  • Comorbidity
  • Diabetes Mellitus, Type 2*
  • Humans
  • Italy / epidemiology
  • Risk Factors
  • SARS-CoV-2