Evaluation of the prognosis of covid-19 patients according to the presence of underlying diseases and drug treatment

Abstract

Certain underlying diseases such as diabetic mellitus and hypertension are a risk factor for the severity and mortality of coronavirus disease (COVID-19) patients. Furthermore, both angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are controversial at role in the process of COVID-19 cases. The aim of the study was to investigate whether underlying diseases and taking ACEi/ARBs, affect the duration of hospitalization and mortality in patients with confirmed COVID-19. Medical usage claims data for the past three years until 15 May, 2020, from the “CORONA-19 International Cooperation Research” project was used. We analyzed the medical insurance claims data for all 7590 coronavirus (COVID-19) patients confirmed by RTPCR tests nationwide up to May 15, 2020. Among the comorbidities, a history of hypertension (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.056–2.158) and diabetes (HR, 1.867; 95% CI, 1.408–2.475) were associated significantly with mortality. Furthermore, heart failure (HR, 1.391; 95% CI, 1.027–1.884), chronic obstructive pulmonary disease (HR, 1.615; 95% CI, 1.185–2.202), chronic kidney disease (HR, 1.451; 95% CI, 1.018–2.069), mental disorder (HR, 1.61; 95% CI, 1.106–2.343), end stage renal disease (HR, 5.353; 95% CI, 2.185–13.12) were also associated significantly with mortality. The underlying disease has increased the risk of mortality in patients with COVID-19. Diabetes, hypertension, cancer, chronic kidney disease, heart failure, and mental disorders increased mortality. Controversial whether taking ACEi/ARBs would benefit COVID-19 patients, in our study, patients taking ACEi/ARBs had a higher risk of mortality.