Comorbidities and Risk Factors for Severe Outcomes in COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study

Fatema S Shaikh; Nahier Aldhafferi; Areej Buker; Abdullah Alqahtani; Subhodeep Dey; Saema Abdulhamid; Dalal Ali Mahaii AlBuhairi; Raha Saud Abdulaziz Alkabour; Waad Sami O Atiyah; Sara Bachar Chrouf; Abdussalam Alshehri; Sunday Olusanya Olatunji; Abdullah M Almuhaideb; Mohammed S Alshahrani; Yousof AlMunsour; Vahitha B Abdul-Salam

doi:10.2147/JMDH.S317884

Comorbidities and Risk Factors for Severe Outcomes in COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study

J Multidiscip Healthc. 2021 Aug 12:14:2169-2183. doi: 10.2147/JMDH.S317884. eCollection 2021.

Authors

Fatema S Shaikh¹, Nahier Aldhafferi¹, Areej Buker¹, Abdullah Alqahtani¹, Subhodeep Dey², Saema Abdulhamid¹, Dalal Ali Mahaii AlBuhairi¹, Raha Saud Abdulaziz Alkabour¹, Waad Sami O Atiyah¹, Sara Bachar Chrouf¹, Abdussalam Alshehri³, Sunday Olusanya Olatunji¹, Abdullah M Almuhaideb¹, Mohammed S Alshahrani⁴, Yousof AlMunsour¹, Vahitha B Abdul-Salam⁵

Affiliations

¹ College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia.
² Indian Institute of Management - Calcutta, Kolkata, India.
³ Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia.
⁴ College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia.
⁵ Centre for Cardiovascular Medicine and Device Innovation, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Abstract

Purpose: The first novel coronavirus disease-19 (COVID-19) case in the Kingdom of Saudi Arabia (KSA) was reported in Qatif in March 2020 with continual increase in infection and mortality rates since then. In this study, we aim to determine risk factors which effect severity and mortality rates in a cohort of hospitalized COVID-19 patients in KSA.

Method: We reviewed medical records of hospitalized patients with confirmed COVID-19 positive results via reverse-transcriptase-polymerase-chain-reaction (RT-PCR) tests at Prince Mohammed Bin Abdulaziz Hospital, Riyadh between May and August 2020. Data were obtained for patient's demography, body mass index (BMI), and comorbidities. Additional data on patients that required intensive care unit (ICU) admission and clinical outcomes were recorded and analyzed with Python Pandas.

Results: A total of 565 COVID-19 positive patients were inducted in the study out of which, 63 (11.1%) patients died while 101 (17.9%) patients required ICU admission. Disease incidences were significantly higher in males and non-Saudi nationals. Patients with cardiovascular, respiratory, and renal diseases displayed significantly higher association with ICU admissions (p<0.001) while mortality rates were significantly higher in COVID-19 patients with cardiovascular, respiratory, renal and neurological diseases. Univariate cox proportional hazards regression model showed that COVID-19 positive patients requiring ICU admission [Hazard's ratio, HR=4.2 95% confidence interval, CI 2.5-7.2); p<0.001] with preexisting cardiovascular [HR=4.1 (CI 2.5-6.7); p<0.001] or respiratory [HR=4.0 (CI 2.0-8.1); p=0.010] diseases were at significantly higher risk for mortality among the positive patients. There were no significant differences in mortality rates or ICU admissions among males and females, and across different age groups, BMIs and nationalities. Hospitalized patients with cardiovascular comorbidity had the highest risk of death (HR=2.9, CI 1.7-5.0; p=0.020).

Conclusion: Independent risk factors for critical outcomes among COVID-19 in KSA include cardiovascular, respiratory and renal comorbidities.

Keywords: COVID-19; KSA; SARS-CoV-2; comorbidities; mortality rate; risk factors.

Grants and funding

This project is sponsored by the COVID-19 grant from King AbdulAziz City of Science and Technology (Grant No. 5-20-01-0700-00016)