Clinical prognosis and risk factors of death for COVID-19 patients complicated with coronary heart disease/diabetes/hypertension-a retrospective, real-world study

Objectives: To explore the clinical prognosis and the risk factors of death from COVID-19 patients complicated with one of the three major comorbidities (coronary heart disease, diabetes, or hypertension) based on real-world data. Methods: This single-centre retrospective real-world study investigated all in-hospital patients who were transferred to the Coronavirus Special Ward of the Elderly Center of Zhongshan Hospital from March to June 2022 with a positive COVID-19 virus nucleic acid test and with at least one of the three comorbidities (coronary heart disease, diabetes or hypertension). Clinical data and laboratory test results of eligible patients were collected. A multivariate logistic regression analysis was performed to explore the risk associated with the prognosis. Results: For the 1,281 PCR-positive patients at the admission included in the analysis, the mean age was 70.5 ± 13.7 years, and 658 (51.4 %) were males. There were 1,092 (85.2 %) patients with hypertension, 477(37.2 %) patients with diabetes, and 124 (9.7 %) patients with coronary heart disease. The length of hospital stay (LOS) was 9.2 ± 5.1 days. Among all admitted patients,1112 (91.5 %) were fully recovered, 77 (6.9 %) were improved, and 29 (2.6 %) died. Over the hospitalization, 172 (13.4 %) PCR-positive patients experienced rebound COVID following initial recovery with a negative PCR test. A multivariate logistic regression analysis showed that vaccination had no protective effects in this study population; Paxlovid was associated with a lower risk of death(OR = 0.98, 95 % CI: 0.95–1.00). Whereas the presence of solid malignancies and nerve system disease were significantly associated with increased risk of death (OR = 1.04, 95 % CI:1.02–1.05; OR = 1.10, 95 % CI:1.05–1.14; OR = 1.08, 95 % CI:1.03–1.13; respectively). Conclusion: The vast majority of the hospitalized COVID patients were fully recovered. Paxlovid was associated with a lower risk of death. In contrast, the presence of solid malignancies and nerve system disease and some treatments were all significantly associated with an increased risk of death.