The Impact of Comorbidities on the Treatment Outcome in Patients With Severe Covid-19-Associated Pneumonia

BACKGROUND . A significant role in the course and outcome of COVID-19, alongside other clinical and laboratory factors, is played by comorbidities. THE AIM OF THE STUDY . We studied the impact of comorbidities on the course and outcomes of severe COVID-19-associated pneumonia. MATERIAL AND METHODS . The study was conducted at the Yakut Republican Clinical Hospital. We analyzed treatment outcomes of 450 patients with severe COVID-19-associated pneumonia who were hospitalized in the intensive care unit. An observational case-control study was conducted, in accordance with the research objective, comorbidities were analyzed in detail in two groups of patients: survivors — 144 (32.0%) and deceased — 306 (68.0%). The endpoint of the study was a fatal outcome. The modified Charlson comorbidity index was used to assess the patients’ comorbidity status. RESULTS . The study revealed the presence of concomitant pathology in 446 (99.1%) patients. 57 (12.7%) patients had two concomitant diseases, 369 (82%) patients had three or more pathologies. A statistically significant impact on the risk of death for the following combinations of comorbid conditions were found: chronic central nervous system diseases with chronic kidney disease; hypertension with chronic kidney disease; coronary heart disease with chronic kidney disease; severe obesity (class III) with coronary heart disease and chronic kidney disease; severe obesity (class III) with type 2 diabetes mellitus. The mortality rate of patients increases linearly with the growth of the Charlson comorbidity index (p<0.001). CONCLUSION . The obtained data indicate a significant increase in the risk of death in patients with severe COVID-19-associated pneumonia in the presence of comorbidities. Therefore, when predicting the outcome and improving the treatment results of this category of patients, one should take into account the patient’s comorbidity.