Association between pre-existing conditions and hospitalization, intensive care services and mortality from COVID-19 - a cross sectional analysis of an international global health data repository

Abstract

Objective: To investigate the association between pre-existing conditions and hospitalization, need for intensive care services (ICU) and mortality due to COVID-19. Methods: We used data on all cases recorded in the Global Health Data repository up to the 10th of March 2021 to carry out a cross-sectional analysis of associations between cardiovascular diseases (CVD), hypertension, diabetes, obesity, lung diseases and kidney disease and hospitalization, ICU and mortality due to COVID-19. We included data from Brazil, Mexico and Cuba only as they were the only countries where preexisting conditions were reported. We used multivariable logistic regression to compute adjusted and unadjusted odds ratios (OR) of the three outcomes for each pre-existing condition in ten-year age groups from 0-9 years and up to 110-120 years. Results: As of the 10th of March 2021, the Global Health repository held 25 900 000 records of confirmed cases of COVID-19, of which 2 900 000 cases from Brazil, Mexico and Cuba had data on preexisting conditions. The overall adjusted odds of hospitalization for each pre-existing condition were; CVD (OR 1.7, 95%CI 1.7-1.7), hypertension (OR 1.5, 95%CI 1.4-1.5), diabetes (OR 2.2, 95%CI 2.1-2.2), obesity (OR 1.7, 95%CI 1.6-1.7), kidney disease (OR 5.5, 95%CI 5.2-5.7) and lung disease (OR 1.9, 95%CI 1.8-1.9). The overall adjusted odds of ICU for each pre-existing condition were; CVD (OR 2.1, 95%CI 1.8-2.4), hypertension (OR 1.3, 95%CI 1.2-1.4), diabetes (OR 1.7, 95%CI 1.5-1.8), obesity (OR 2.2, 95%%CI 2.1-2.4), kidney disease (OR 1.4, 95%CI 1.2-1.7) and lung disease (OR 1.1, 95%CI 0.9-1.3). The overall adjusted odds of mortality for each pre-existing condition were; CVD (OR 1.7, 95%CI 1.6-1.7), hypertension (OR 1.3, 95%CI 1.3-1.4), diabetes (OR 2.0, 95%CI 1.9-2.0), obesity (OR 1.9, 95%CI 1.8-2.0), kidney disease (OR 2.7, 95%CI 2.6-2.9) and lung disease (OR 1.6, 95%CI 1.5-1.7). The odds of each outcome were considerably larger in children and young adults with these preexisting conditions than for adults, especially for kidney disease, CVD and diabetes. Conclusion: Individuals with CVD, hypertension, diabetes, obesity, lung diseases and kidney diseases have high odds of hospitalization, ICU and mortality from COVID-19. The odds of these outcomes are especially elevated in children and young adults with these preexisting conditions