Shereen Elghazaly

Background: Older persons and people of any age with certain underlying comorbidities such as diabetes mellitus, cardiovascular disease, lung disease, kidney disease, liver disease, and cancer are at a higher risk of severe disease course and death if they become infected with COVID-19. Identifying at-risk groups and risk factors for COVID-19 severity and mortality is important for guiding the efficient and appropriate prevention and management of patients with COVID-19. Objective: This study aimed at describing the demographics and epidemiologic characteristics of confirmed COVID-19 cases in Egypt and determining the impact of different comorbidities on patients’ outcomes. Methods: The data of all confirmed COVID-19 patients admitted to 408 governmental hospitals all over Egypt from February to May 2020 were collected retrospectively from the National Egyptian Disease Surveillance System. The cases were confirmed using RT-PCR. Results: Overall, 28,415 patients (55% male and 45% female) were identified. Their median age was 44 years. Of those, 743 (2.6%) were admitted to ICU, 408 (1.4%) required ventilator, and 1045 (3.7%) died. Of the 21,617 (76.1%) patients with completed data, 4687 (21.7%) had comorbidities. Overall, 11.8% had diabetes, 5.3% cardiovascular disease, and 4.3% chronic obstructive pulmonary disease. Those who had 1 comorbidity were more likely to die (odds ratio 2.83), were admitted to ICU (odds ratio 6.36), and needed a ventilator (odds ratio 5.95) compared to patients with no comorbidities. Having multiple comorbidities increased the risk of mortality (odds ratio 3.53), ICU admission (odds ratio 8.62), and requiring a ventilator (odds ratio 9.06). Conclusions: COVID-19 patients with comorbidities had a higher risk of disease severity and mortality. Multiple comorbidities further increase the risk to a higher extent. All necessary precautions should be taken for patients with comorbidities to avoid COVID-19 infection in order to prevent the worst prognosis.

BACKGROUND Older persons and people of any age with certain underlying comorbidities such as diabetes mellitus, cardiovascular disease, lung disease, kidney disease, liver disease, and cancer are at a higher risk of severe disease course and death if they become infected with COVID-19. Identifying at-risk groups and risk factors for COVID-19 severity and mortality is important for guiding the efficient and appropriate prevention and management of patients with COVID-19. OBJECTIVE This study aimed at describing the demographics and epidemiologic characteristics of confirmed COVID-19 cases in Egypt and determining the impact of different comorbidities on patients’ outcomes. METHODS The data of all confirmed COVID-19 patients admitted to 408 governmental hospitals all over Egypt from February to May 2020 were collected retrospectively from the National Egyptian Disease Surveillance System. The cases were confirmed using RT-PCR. RESULTS Overall, 28,415 patients (55% male and 45% female) were identified. Their median age was 44 years. Of those, 743 (2.6%) were admitted to ICU, 408 (1.4%) required ventilator, and 1045 (3.7%) died. Of the 21,617 (76.1%) patients with completed data, 4687 (21.7%) had comorbidities. Overall, 11.8% had diabetes, 5.3% cardiovascular disease, and 4.3% chronic obstructive pulmonary disease. Those who had 1 comorbidity were more likely to die (odds ratio 2.83), were admitted to ICU (odds ratio 6.36), and needed a ventilator (odds ratio 5.95) compared to patients with no comorbidities. Having multiple comorbidities increased the risk of mortality (odds ratio 3.53), ICU admission (odds ratio 8.62), and requiring a ventilator (odds ratio 9.06). CONCLUSIONS COVID-19 patients with comorbidities had a higher risk of disease severity and mortality. Multiple comorbidities further increase the risk to a higher extent. All necessary precautions should be taken for patients with comorbidities to avoid COVID-19 infection in order to prevent the worst prognosis.

BACKGROUND Older population and people of any age with underlying certain comorbidities such as diabetes mellitus, cardiovascular, lung disease, kidney disease, liver disease and cancer are at higher risk of severe disease course and death if they become infected with COVID-19. Identifying risky group and risk factors for COVID-19 severity and mortality is important for guiding efficient and appropriate prevention and management of patients with COVID-19. OBJECTIVE This study aims at describing demographics and epidemiologic characteristics of confirmed COVID-19 cases in Egypt and determine the impact of different comorbidities on patients’ outcomes. METHODS Data of all confirmed COVID-19 patients admitted to 408 governmental hospitals allover Egypt February-May 2020 were collected retrospectively from the National Egyptian Disease Surveillance System. Cases were confirmed using RT-PCR. RESULTS Overall, 28,415 patients (55.0% males, 45.0% females) were identified. Their median age was 44 years. Of those, 743(2.6%) were admitted to ICU, 408(1.4%) required ventilator and 1,045(3.7%) died. Of 21,617(76.1%) patients with completed data, 4,687(21.7%) had comorbidities. Overall, 11.8% had diabetes, 5.3% cardiovascular disease and 4.3% chronic obstructive pulmonary disease. Those with one comorbidity were more likely to die (OR = 2.83), admitted to ICU (OR = 6.36) and need ventilator (OR = 5.95) compared to patients with no comorbidities. Having multiple comorbidities increased risk of mortality (OR = 3.53), ICU admission (OR = 8.62), and requiring ventilator (OR = 9.06). CONCLUSIONS COVID-19 Patients with comorbidities had higher risk of disease severity and mortality. Multiple comorbidities further increase the risk to higher extent. All necessary precautions should be taken for patients with comorbidities to avoid COVID-19 infection to prevent the worst prognosis.