摘要：Coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 has continued to influence healthcare dynamics, social patterns, and economic systems worldwide. As of mid-March 2021, COVID-19 has already resulted in more than 97,000 infections and 1,690 deaths in South Korea. To date, no treatment has demonstrated its effectiveness with a sufficient level of scientific evidence. Fortunately, a major milestone in the efforts against this pandemic was the rapid and successful development of different vaccines against COVID-19. However, the development of vaccines alone cannot overcome COVID-19. Until the transition to normalcy is achieved, appropriate management for high-risk groups will continue to be one of the main strategies for combating COVID-19.
It has been recommended that patients with high risk for COVID-19 should be given access to early diagnosis and management.
1 Older patients and those with underlying comorbidities or at long-term care facilities may be vulnerable to COVID-19 outbreaks or an increased risk of poor prognosis and death.
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3 Most patients with dementia have these 3 risk factors.
We conducted a retrospective observational study to examine the relationship between the mortality of patients with COVID-19 infection and underlying comorbidities, including dementia. Using de-identified data from the Health Insurance Review and Assessment Service (HIRA) of Korea, which were collected until April 8, 2020, we analyzed all patients who had been tested for COVID-19 and who had a history of medical service use for the past 5 years. All patients with COVID-19 were categorized as reverse transcription polymerase chain reaction (RT-PCR) test-positive cases when the diagnosis was confirmed by RT-PCR using respiratory tract specimens. Underlying comorbidities were selected with reports of possible association with COVID-19 in Charlson's comorbidities and previous methods with HIRA of Korea. Thus, the following data were extracted: age at the time of diagnosis, sex, underlying comorbidities during the past 5 years, and mortality. The comorbidities were as follows: hypertension, heart failure, chronic kidney disease, chronic lung disease, diabetes mellitus, ischemic heart disease, dyslipidemia, history of malignancy, arthritis or arthropathy, stroke, Parkinson's disease, epilepsy, and dementia (
Supplementary Table 1). Non-surviving patients were identified in addition to those who had died despite medical intervention after confirmation of COVID-19.
A total of 1,697 COVID-19 patients with a PCR-confirmed diagnosis were identified. The mean±standard deviation for age was 47.0±21.4 years (with 30.6% of patients ≥60 years old), and 41.7% of the patients were men. The overall mortality was 3.5% (59 of 1,697 patients) in this study population. By a multivariable logistic regression analysis, independent predictors of in-hospital death for COVID-19 were old age (odds ratio [OR
