Study examines factors associated with COVID-19 mortality

by Leo Almazora14 Sep 2020

A group of U.K. researchers have shared their findings on how race, age, and comorbidities impact mortality among patients with COVID-19 in a newly published study.

The paper, published on PLOS and titled Comorbidities Associated with Mortality in 31,461 Patients with COVID-19 in the United States: A Federated Electronic Medical Record Analysis, comes from a team of authors from Liverpool Center for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital in the United Kingdom, as well as TrinetX.

A global health research network based in the U.S., TrinetX describes itself as “the market leader in protocol design, feasibility and site selection” for clinical trials. It covers 150 healthcare organizations across 25 countries, and collaborates with most of the corporate leaders into the industry, including 13 of the top 15 pharmaceutical companies.

The researchers analysed data from de-identified electronic medical records of COVID-19 patients across a network of 29 healthcare organizations in the U.S. The network was searched between January 20 and May 26, 2020, and the sample population had a median age of 50 years, with 54.5% being female.

“We determined associations between age, sex, ethnicity, comorbidities, and death with COVID-19 during the study period,” the authors said.

After accounting for other factors, they found that being older, being male, and being Black or African American were all associated with higher odds of death from COVID-19.

They also found a higher probability of death among COVID-19 patients with different co-morbidities, including a history of:

  • myocardial infarction;
  • congestive heart failure;
  • dementia;
  • chronic pulmonary disease;
  • mild liver disease;
  • moderate/severe liver disease;
  • renal disease; and
  • metastatic solid tumour.

The researchers also examined how the strength of the associations between the different factors and COVID-19 mortality varied across different age groups. Older age, being male, and belng Black or African American were consistently associated with higher odds of death across all age groups, as were comorbidities with myocardial infarction and renal diseases.

A history of mild liver disease and malignancy were associated with higher odds of death among COVID-19 patients who were less than 50 years old. For patients aged 50 to 69 years old, a higher probability of death manifested among those with a history of congestive heart failure, chronic pulmonary disease, moderate/severe liver disease, metastatic solid tumour, and AIDS/HIV. Meanwhile, a history of congestive heart failure and dementia were correlated with higher odds of death among people aged 70 to 90 years old.

The researchers acknowledged that the study has limitations. Aside from the possibility of some health conditions having been incorrectly coded into electronic medical records, they said that some deaths of COVID-19 patients in the study might not have been captured in their records.