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. 2024 Aug 2;10(15):e35570.
doi: 10.1016/j.heliyon.2024.e35570. eCollection 2024 Aug 15.

Unravelling the complex interplay of age, comorbidities, and multimorbidities in COVID-19 disease progression: Clinical implications and future perspectives

Maria Shoukat  1   2 , Haseeb Khan  1 , Wajid Munir  3 , Moona Nazish  4 , Abdulwahed Fahad Alrefaei  5 , Mohammed Fahad Albeshr  5 , Anwar Ali  6   7 , Saad Ahmed  3 , Afsheen Mansoor  8 , Massab Umair  2 , Muhammad Suleman Rana  2 , Malik Badshah  1
Affiliations

Unravelling the complex interplay of age, comorbidities, and multimorbidities in COVID-19 disease progression: Clinical implications and future perspectives

Maria Shoukat et al. Heliyon. .

Abstract

Introduction: The COVID-19 infection as an inflammatory disease has posed significant challenges to global public health due to multi-factor risks associated with it leading to disease severity and mortality. Understanding the effect of age and comorbidities on overall disease progression is crucial to identify highly susceptible individuals and to develop effective disease management strategies in a resource limited country like Pakistan.

Methodology: A retrospective study was conducted on hospitalized COVID-19 patients to assess the prevalence of various comorbidities among different age groups and their effect on disease severity and mortality rate.

Results: In this retrospective study, a cohort of 618 hospitalized COVID-19 patients was analyzed, consisting of 387 males (62.6 %) and 231 females (37.4 %). Notably, the young age group (15-24 years), had the lowest frequency of hospitalized COVID-19 patients, while no case was observed in children (≤14 years) showing a significant association (p < 0.001) of age and disease prevalence. Comorbidities were observed in 63.9 % of COVID-19 patients including hypertension (HTN), diabetes mellitus (DM), ischemic heart diseases (IHD), asthma, chronic kidney disease (CKD) and tuberculosis (TB). The most common comorbidities were HTN (42.1 %) followed by DM (33.8 %), IHD (16.5 %), asthma (11.2 %), CKD (7.9 %) and TB (1.9 %).Furthermore, the study revealed a significant association between comorbidities, age groups, and the need for non-invasive ventilation (NIV) (p < 0.001), mechanical ventilation (MV) (p < 0.001), and intensive care unit (ICU) admission (p < 0.001). Patients with specific comorbidities and those in the older age group (≥65 years) demonstrated a higher need for these interventions. However, patients without any comorbidity consistently exhibited the highest cumulative proportion of survival at each time point, indicating better overall survival outcomes. In contrast, patients with multimorbidities of DM/HTN/IHD, HTN/IHD, and DM/HTN/CKD had comparatively lower survival rates and higher mortality rates (p < 0.001).

Conclusion: This research highlights the significant impact of age, comorbidities and multimorbidities on the severity and mortality of COVID-19 patients. It highlights the importance of considering these factors in tailoring effective management strategies for patients with COVID-19 or other infectious respiratory diseases.

Keywords: Age; COVID-19; Chronic kidney disease; Comorbidity; Diabetes mellitus; Hypertension; Ischemic heart disease; Multimorbidity.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
STROBE flow chart for retrospective observational study.
Fig. 2
Fig. 2
Frequency (%) of death and recovery in comorbid/multimorbid COVID-19 patients.
Fig. 3
Fig. 3
Association between comorbidities/multimorbidities and probability of survival.
See this image and copyright information in PMC

References

    1. Shoukat M., Khan S., Islam A., Azam M., Badshah M. Viral and Antiviral Nanomaterials. CRC Press; 2022. Emerging nanotechnology-enabled approaches to mitigate COVID-19 pandemic; pp. 265–283.
    1. Li M., et al. COVID-19 vaccine development: milestones, lessons and prospects. Signal Transduct. Targeted Ther. 2022;7(1):146. - PMC - PubMed
    1. Jafari A., Danesh Pouya F., Niknam Z., Abdollahpour-Alitappeh M., Rezaei-Tavirani M., Rasmi Y. Current advances and challenges in COVID-19 vaccine development: from conventional vaccines to next-generation vaccine platforms. Mol. Biol. Rep. 2022;49(6):4943–4957. - PMC - PubMed
    1. Wu Q. Vol. 381. British Medical Journal Publishing Group; 2023. (“Understanding the Burden of Post-covid-19 Condition,” Bmj). - PubMed
    1. Edwin H.V., Antony C.S. An update on COVID-19: SARS-CoV-2 variants, antiviral drugs, and vaccines. Heliyon. 2023;9(3):e13952. - PMC - PubMed

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