Common hospital complications associated with COVID-19 identified in a retrospective cohort study

1. The most common complications associated with COVID-19 with high absolute risk were viral pneumonia, respiratory failure, acute kidney failure, and sepsis.

2. Complications highly associated with COVID-19 with low absolute risk were myocarditis, pneumothorax, and disseminated intravascular coagulation.

Evidence Rating Level: 2 (Good)

During the COVID-19 pandemic, greater than 50 million individuals worldwide have been diagnosed with the disease. Although most people present with mild or no symptoms, 20% of patients have had severe cases requiring hospitalization. Respiratory sequelae such as pneumonia have been identified as common complications of COVID-19. However, previous literature often relied on small cohorts that could not estimate the risk of various COVID-19 complications. The current retrospective cohort study aimed to identify complications that were highly associated with COVID-19, and to estimate the odds ratio and absolute risk of developing these complications. The study population comprised of 70,288 patients diagnosed with COVID-19 in the United States. Medical claims data was used to compare diagnoses made in a patient’s “hazard” period (between 7 days prior to and 30 days after a COVID-19 diagnosis) to diagnoses made in the baseline period (between 120 days prior and 30 days prior to COVID-19 diagnosis). The results found 69 diagnoses that were significantly associated with COVID-19 diagnosis. As expected, the most common diagnoses included respiratory conditions, such as viral pneumonia (odds ratio 177.63, 95% CI 147.19–214.37, absolute risk 27.6%) and respiratory failure (OR 11.36, 95% CI 10.74–12.02, absolute risk 22.6%),  in addition to other common conditions such as acute kidney failure (OR 3.50, 95% CI 3.34–3.68, absolute risk 11.8%) and sepsis (OR 4.23, 95% CI 4.01–4.46, absolute risk 10.4%). Conditions that had high association with COVID-19 diagnosis but low absolute risk included myocarditis, pneumothorax, and disseminated intravascular coagulation (absolute risk ranging from 0.1-0.4%). Overall, this study demonstrated identified several complications associated with COVID-19, which can help inform patient management and treatment decisions for COVID-19 patients.

Click to read the study in CMAJ

Image: PD

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