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Diabetes, obesity, high blood pressure, and cardiovascular disease are known risk factors for COVID-19.
However, among coronary patients who received treatment in the intensive care unit, none of these underlying diseases could be directly related to higher mortality, Aftonbladet writes.
It appears from a Swedish study that includes 1,563 patients.
The study’s lead author is Michelle Chew, a professor of intensive care at Linköping University Hospital. Co-authors include Swedish state epidemiologist Anders Tegnell.
The research report is what is called a draft version, and therefore has not yet been peer-reviewed or published in a scientific journal.
26.7 percent died
The study includes all patients who were in the intensive care unit in Sweden between March 6 and May 6.
Patients were followed up for 30 days after admission, and within 30 days, 26.7% of them had died.
66.8 percent of the 1,563 patients had at least one underlying disease. High blood pressure, diabetes, obesity, and chronic heart and lung disease were the most common.
With the exception of chronic lung disease, the presence of underlying diseases was not independently associated with increased mortality, the researchers conclude.
Furthermore, the authors of the article write that mortality appears to depend on age, severity of disease, and degree of organ failure, rather than on existing underlying diseases, so-called comorbidities.
In their analysis, the Swedish researchers were unable to link diabetes, obesity, high blood pressure, chronic heart disease or chronic kidney failure with higher mortality among COVID-19 patients in intensive care.
– surprising
However, the researchers found that mortality increased dramatically with age.
While only 13.1 percent of patients younger than 50 died, the death rate was 60.4 percent among patients older than 80.
– That arterial hypertension, chronic heart disease and obesity were not significant in our multivariate analysis was surprising. I want to emphasize that these factors still posed a risk when examined individually, in a so-called univariate analysis, study first author Michelle Chew tells Dagbladet.
He emphasizes that the study deals exclusively with the results after intensive care.
– Chronic diseases that require medical attention have previously been identified as a risk of developing covid-19. Our results do not mean that these diseases are harmless for COVID-19. However, the incidence of organ failure and the degree of lung failure were major risk factors for death, emphasizing the importance of preventing organ failure and worsening lung status when patients develop coronavirus disease, Chew says.
She points out as positive that only one in four, who had to be in intensive care due to covid-19, died.
– Is not easy
Deputy Health Director Espen Rostrup Nakstad believes that the Swedish study as a whole does not provide much new clinical insights that can be used in treating patients, but that it complements the general knowledge base on covid-19.
He also notes that it can be difficult to distinguish factors such as age, underlying disease, and organ failure during intensive care as a cause of increased mortality, as these three factors are related.
– Many older people have, for example, underlying diseases such as high blood pressure, cardiovascular disease and diabetes. Therefore, it is easy to point to them as the main cause of a severe disease course in covid-19, as the authors of this Swedish study also point out. As we know, the same patients also have old age, which is a strong and independent risk factor, and there is always a failure in one or more organ systems that leads them to the intensive care unit, says the man from the Directorate of Health of Norway and adds:
– Therefore, it is not so easy to conclude with clear isolated causal relationships between risk factors and death in covid-19, but the association is that old age means a lot in most studies. It’s also pretty obvious that serious illnesses are more strongly correlated with death than non-serious illnesses, Nakstad says.
You have to be careful
The professor of anesthesia and intensive care at Lund University and chief physician in Malmö, Jonas Åkesson, emphasizes that the study results do not exclude a connection between the underlying diseases and the fatal course of COVID-19.
– I am surprised that lung diseases were the only underlying disease that prevailed, but we cannot conclude that there are no other connections. My particular view remains that people with serious chronic illnesses should be careful in crown times, Åkesson tells Swedish Radio.
