Comorbidities as Risk Factors for Mortality in COVID-19 Acute Respiratory Distress Syndrome Adult Patients: A Single-Center Retrospective Study

Abstract

Background: Geriatric, obesity, and chronic disease are classified as risk factors for adverse outcomes of coronavirus disease 2019 (COVID-19). Studies regarding the importance of these comorbidities in COVID-19 with severe complications such as acute respiratory distress syndrome (ARDS) are scarce. This study aims to analyze age, obesity, and chronic disease comorbidities as risk factors for 28-days mortality in COVID-19 patients with ARDS. Methods: A retrospective, single-center study was conducted in Dr. Soetomo General Hospital, Surabaya, Indonesia between July-October 2020. We included all adult inpatients (≥18 years old) of confirmed COVID-19 with ARDS. Demographic, comorbidities, initial PaO2/FiO2 ratio, time of discharge or death were obtained from medical records and compared the ARDS severity between survivors and non-survivors. The univariate and multivariate logistic regression methods were used to identify risk factors associated with in-hospital death. Result: Among 102 patients of COVID-19 with ARDS, the median age is 52 years. Most of them are within 50 – 59 age categories. The median hospital length of stay (LOS) for survivor is 22 (15.7 – 26) days and 9 (4.25 – 14.4) days for non-survivor. The 28-days mortality rate is 48 (47.1%) patients. Age > 65 years old (HR= 2.7, 95% CI 1.39 – 5.44, p value= 0.004), obesity (HR= 2.2, 95% CI 1.16 – 4.51, p value= 0.016), and chronic hypertension (HR= 1.98, 95% CI 1.11 – 3.52, p value= 0.02) are the independent risk factors for 28-days mortality in COVID-19 with ARDS. Conclusion: Geriatric, obesity, and chronic hypertension comorbidities are the risk factors for mortality of COVID-19 with ARDS complications.