Clinical Profile and Severity Spectrum of COVID-19 Patients with and without Comorbidities Admitted to a Tertiary Care Hospital in India.

BACKGROUND

COVID-19 severity is influenced by age, sex and chronic comorbidities; therefore, unadjusted comparisons may overestimate the independent effect of comorbidity.

OBJECTIVE

This revised analysis aimed to compare the clinical profile and disease severity of hospitalized COVID-19 patients without comorbidity, with a single comorbidity and with multiple comorbidities, and to determine whether comorbidity status remained associated with severe disease after adjustment for age and sex.

METHODS

A retrospective record-based cross-sectional study was conducted among 255 adult RT-PCR/RAT-confirmed COVID-19 patients admitted to a tertiary care hospital in Ratlam, Madhya Pradesh, India, from January to March 2021. Patients were categorized as non-comorbid (n=127), single-comorbidity (n=78) and multiple-comorbidity (n=50). Descriptive statistics, chi-square testing, independent t-test and multivariable binary logistic regression were applied.

RESULTS

The mean age was higher in comorbid than non-comorbid patients (62.4 ± 12.1 vs 46.2 ± 15.9 years; p<0.001), whereas sex distribution showed no statistically significant difference (p=0.069). Fever (65.49%), cough (53.72%) and dyspnea (33.72%) were the predominant symptoms. Hypertension (71.87%), diabetes mellitus (34.37%) and cardiac disease (12.50%) were the leading comorbidities. Severe disease occurred in 10.23% of non-comorbid patients, 24.36% of single-comorbidity patients and 42.00% of patients with multiple comorbidities (p<0.001). In adjusted analysis, age ≥60 years [adjusted odds ratio (OR) 3.28, 95% confidence interval (CI) 1.62-6.64; p=0.001], male sex (adjusted OR 1.41, 95% CI 0.70-2.86; p=0.338), single comorbidity (adjusted OR 2.05, 95% CI 0.89-4.72; p=0.092) and multiple comorbidities (adjusted OR 3.86, 95% CI 1.56-9.55; p=0.004) were evaluated as predictors of severe disease.

CONCLUSION

Comorbidity burden showed a graded association with COVID-19 severity, particularly among patients with multiple chronic conditions. However, interpretation should account for the confounding effect of age and the limitations of retrospective single-centre data.