The Impact of Comorbidities and Obesity on the Severity and Outcome of COVID-19 in Hospitalized Patients-A Retrospective Study in a Hungarian Hospital

Abstract

Patients with comorbidities and obesity are more likely to be hospitalized with coronavirus disease 2019 (COVID-19), to have a higher incidence of severe pneumonia and to also show higher mortality rates. Between 15 March 2020 and 31 December 2021, a retrospective, single-center, observational study was conducted among patients requiring hospitalization for COVID-19 infection. Our aim was to investigate the impact of comorbidities and lifestyle risk factors on mortality, the need for intensive care unit (ICU) admission and the severity of the disease among these patients. Our results demonstrated that comorbidities and obesity increased the risk for all investigated endpoints. Age over 65 years and male sex were identified as independent risk factors, and cardiovascular diseases, cancer, endocrine and metabolic diseases, chronic kidney disease and obesity were identified as significant risk factors. Obesity was found to be the most significant risk factor, associated with considerable odds of COVID-19 mortality and the need for ICU admission in the under-65 age group (aOR: 2.95; p < 0.001 and aOR: 3.49, p < 0.001). In our study, risk factors that increased mortality and morbidity among hospitalized patients were identified. Detailed information on such factors may support therapeutic decision making, the proper targeting of vaccination campaigns and the effective overall management of the COVID-19 epidemic, hence reducing the burden on the healthcare system.

Keywords: COVID-19; Hungary; ICU admission; SARS-CoV-2; comorbidities; disease severity; mortality; obesity.

Figure 1

Forest plot graph representing the impacts of comorbidities and obesity on COVID-19-related mortality and the need for ICU treatment. (a) Association between comorbid diseases, obesity and death from SARS-CoV-2. (b) Association between comorbid diseases, obesity and the need for ICU admission. * Indicates p < 0.05 and ** indicates p < 0.01. Error bars indicate the 95% confidence interval for each correlation. ^† Other comorbidities: neurological and mental health conditions, hematologic diseases, autoimmune diseases, BPH and other urological disorders, rheumatological and orthopedic conditions, etc.