Lifestyle diseases raise mortality risk in COVID-19 patients

Muscat: Long-term medical conditions such as diabetes and hypertension in COVID-19 patients lead to increased chances of mortality, a new academic study published by a group of researchers working in the country has revealed.
The study, titled ‘Clinical characteristics and outcomes of the first 63 adult patients hospitalised with COVID-19: An experience from Oman,’ analysed the medical condition of patients from two hospitals in the country – Royal Hospital and Al Nahdha Hospital – which also took into account any pre-existing conditions they presented.
The study shows that diabetes mellitus (DM) and hypertension were the most common comorbidities, followed by cardiovascular disorders and chronic renal diseases. The age range of patients hospitalised due to the disease was from 22 to 87 years.
“The study population included 63 hospitalised patients with confirmed COVID-19,” said the study. “54 per cent (34 people) and 46 per cent (29 people) were admitted to Royal and Al Nahdha hospitals, respectively. A total of 84 per cent (53 people) of the patients were males and 46 per cent (29 people) were Omani citizens.
“Nearly 78 per cent (49 people) of the patients were employed, whether full, part-time, or self-employed,” added the study. “Thirteen per cent (eight people) of the patients had a history of travel to a country with local COVID-19 transmission and 22 per cent (14 people) had a contact with a known COVID-19 patient, mostly through household contact.
“The remaining almost two-thirds of the patients had an unknown mode of infection. Fifty one per cent (32 people) of patients had at least one co-morbidity with DM (32 per cent, 20 people) and hypertension (32 per cent, 20 people) as the most common comorbidities followed by chronic heart and renal diseases (12.8 per cent, eight people),” it said. A total of 24 patients in this study were admitted to the ICU as part of their COVID-19 treatment process.
The study was co-authored by 12 medical professionals and researchers in Oman. Among them, Faryal Khamis, Hamed Al Naamani, Nenad Pandak, Maher Al Bahrani, Zakariya Al Bulushi, Huda Al Khalili and Issa Al Salmi were from the Royal Hospital. Ibrahim Al Zakwani belonged to the College of Medicine and Health Sciences at Sultan Qaboos University, Sultan Al Lawati and Ruwaida Al Salmi belonged to Al Nahdha Hospital, Salah Al Awaidy worked for the Ministry of Health, and Muna Ba Omar represented the Oman Medical Specialty Board.
“ICU admission, those on mechanical ventilation, the elderly, those with high total bilirubin and low corrected calcium were associated with high mortality in hospitalised COVID-19 patients,” they said.
Among the non-Omani patients included in the study, 14 were from India, 10 from Bangladesh, five from Pakistan, two from Lebanon and one each from Ireland, Sudan and the UK. The patients in this study had, in total, travelled to eight countries overseas, including Indonesia, Pakistan Saudi Arabia, Turkey, the UK, the UAE and the US. All but two of the patients had been treated with either chloroquine or hydroxychloroquine.
“The majority of our patients were middle-aged men with no history of travel or contact with COVID-19 patients,” the authors added in their report. “The male predominance has been consistent with a number of studies, as it is hypothesised that the X chromosome contains a high density of immune-related genes and regulatory elements that are extensively involved in both the innate and adaptive immunity."
“However, in our study this is probably related to different lifestyles between men and women, especially among men who were mostly foreign-born labourers,” they went on to say. “In comparison to other published studies, this work illustrated that foreign-born population constitutes a disproportionately greater number of reported COVID-19 cases. No such disparities are evident in other countries outside the GCC."
“Several factors increase the likelihood of exposure to COVID-19 among this population that include: poor standards of living, crowdedness as mostly they live in big cities (urban), lack of awareness of the COVID-19 signs and symptoms and the general preventive measures due to language barriers, late presentation to health facilities that allows a higher chance of acquisition of the disease and transmission to others especially during asymptomatic stage,” the study explained. “Effective strategies need to be in place to manage foreign-born populations.”