Is Comorbidity or Age Important in the Hospitalization Decision in COVID-19 Patients? A Case-Control Study
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Abstract
Aim: COVID-19 is an important problem, and comorbidities may worsen the course of the disease. We aimed to investigate the role of comorbidities in COVID-19 patients hospitalized for outpatient treatment failure.
Methods: Hospitalized COVID-19 patients were included in this study between March 1 and May 15, 2020. Those hospitalized due to treatment failure were defined as Group-1, and those hospitalized at first admission were defined as Group-2. Demographic information, comorbidities, laboratory data, and clinical results of the patients were examined.
Results: A total of 514 patients were included in the study; 19.3% (n=99) were patients who worsened despite outpatient treatment (Group-1), and 80.7% (n=415) were hospitalized at first admission (Group-2). Group-1 cases were younger, but comorbidities were as high as the older Group-2 cases. We found that increasing age increases the risk of hospitalization (OR=1.02), bronchiectasis reduces the risk of hospitalization (OR=0,109), and other comorbidities have no impact on the risk of hospitalization. There was no difference between groups according to ICU transfer (Group-1: 6.1%, Group-2: 9.2%, p=0.32), hospital discharge rates (Group-1: 100%, Group-2: 96.6%, p=0,064), and mortality rates (p=0.064). In Group-1, leukocyte, thrombocyte, neutrophil, lymphocyte, eosinophil, monocyte, and basophil values were lower, and urea and D-Dimer values were higher than Group-2.
Conclusions: This study identified age as a factor in increasing hospitalization in COVID-19 patients. On the other hand, the presence of bronchiectasis in patients appears to be a factor in reducing hospitalization. This situation raises a new question about whether the permanent dilation resulting from the damage caused by bronchiectasis in the bronchi could act as a preventive factor for the coronavirus. We believe that well-designed studies involving a large case series could lead the way in exploring this aspect further.