Impact of Comorbidities on the Risk of Death and Intensive Care Admission in COVID-19 Patients Hospitalized in a North-African Center

Dhekra Chebil; Sana Rouis; Amal Smati; Hajer Hannachi; Wided Dabbebi; Hela Sakly; Jihene Ayachi; Takoua Bouhdida; Boutheina Trabelsi; Fadoua Chortani; Chaker Jarray; Slim Samet; Latifa Merzougui

doi:10.61838/kman.najm.1.1.7

Authors

Dhekra Chebil Preventive Medicine Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia-Faculty of Medicine of Sousse, University of Sousse, Tunisia Translator https://orcid.org/0000-0002-5099-0714
Sana Rouis Infectious Diseases Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia-Faculty of Medicine of Sousse, University of Sousse, Tunisia Author https://orcid.org/0000-0002-5099-0714
Amal Smati Faculty of Medicine of Sousse, University of Sousse, Tunisia Author https://orcid.org/0000-0002-5099-0714
Hajer Hannachi Preventive Medicine Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia-Faculty of Medicine of Sousse, University of Sousse, Tunisia Author https://orcid.org/0000-0002-5099-0714
Wided Dabbebi Department of Medicine, Ibn Al Jazzar University Hospital, Kairouan, Tunisia-Faculty of Medicine of Sousse, University of Sousse, Tunisia Author https://orcid.org/0000-0002-5099-0714
Hela Sakly Infectious Diseases Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia-Faculty of Medicine of Sousse, University of Sousse, Tunisia Author https://orcid.org/0000-0002-5099-0714
Jihene Ayachi Intensive Care Unit, Ibn Al Jazzar University Hospital, Kairouan, Tunisia-Faculty of Medicine of Sousse, University of Sousse, Tunisia Author https://orcid.org/0000-0002-5099-0714
Takoua Bouhdida Preventive Medicine Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia Author https://orcid.org/0000-0002-5099-0714
Boutheina Trabelsi Preventive Medicine Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia Author https://orcid.org/0000-0002-5099-0714
Fadoua Chortani Preventive Medicine Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia Author https://orcid.org/0000-0002-5099-0714
Chaker Jarray Preventive Medicine Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia Author https://orcid.org/0000-0002-5099-0714
Slim Samet Department of Medicine, Ibn Al Jazzar University Hospital, Kairouan, Tunisia Author https://orcid.org/0000-0002-5099-0714
Latifa Merzougui Preventive Medicine Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia-Faculty of Medicine of Sousse, University of Sousse, Tunisia Author https://orcid.org/0000-0002-5099-0714

DOI:

https://doi.org/10.61838/kman.najm.1.1.7

Keywords:

Arterial Hypertension, Comorbidity, Diabetes Mellitus, Hospital Mortality, Intensive Care Units, Kaplan-Meier Estimate, Proportional Hazards Models, SARS-CoV-2, Tunisia

Abstract

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has posed significant challenges to global health, with variations in outcomes among affected individuals. Comorbidities are known to influence the prognosis of various diseases, but their specific impact on COVID-19 patients in North-African settings remains to be elucidated. To evaluate the risk of death and intensive care unit (ICU) transfer in patients with COVID-19 by stratifying on comorbidity status.

Methods: Data of confirmed hospitalized patients at the university hospital of Kairouan (Tunisia) between September 2020 and August 2021 were collected. Composite endpoints including admission to an ICU or death were analysed. The risk of reaching the composite endpoint was compared according to the presence and number of comorbidities. Kaplan-Meir methods and Cox proportional hazards regression models were used to study the time to composite endpoint and estimate its prognostic factors.

Results: A total of 866 patients were included. The mean age was 65 ± 14 years. Most common comorbidities were arterial hypertension (41.1%) and diabetes mellitus (31.2%). Overall, 316 (36.5%) patients reached the composite endpoint: 263(30.4%) patients died and 53 (6.1%) were admitted to the ICU. Cardiovascular disease and chronic renal failure were associated with higher risk of reaching the composite endpoints.

Conclusion: COVID-19 patients with comorbidities were more likely to experience severe outcomes. Aggressive strategies to control the COVID-19 pandemic should target patients with chronic diseases, especially cardiovascular disease, and chronic renal failure, as a priority.