Comorbidities Associated with In-Hospital Mortality in Adult Patients with COVID-19 in Lima, Peru: A Retrospective Cohort Study

Background: We aimed to determine the comorbidities associated with in-hospital mortality in different age groups of hospitalized patients in Lima and Callao. Methods: In this retrospective cohort study, we analyzed data from hospitalized COVID-19 patients reported to the National Epidemiological Surveillance System (NotiWeb) of the Peruvian Ministry of Health from March 5, to October 31, 2020. Multiple logistic regression was used to determine the associated comorbidities with in-hospital mortality in the different age groups according to the Peruvian Ministry of Health life stage classification: youth (18-29 years), adults (30-59 years) and older adults (≥60 years). Findings: Among, 45639 patients, 2084 youth, 21206 adults, and 22349 older adults were included. Older adults had a higher mortality rate (59.9%) compared to adults (24.7%), and youth (6.7%) (Log-rank test: p<0.001). In young patients, kidney disease (OR, 7.94; 95% CI, 2.38-26.50), chronic neurological disease (OR, 10.38; 95% CI, 2.31–46.57), and cancer (OR, 16.60; 95% CI, 3.75–73.53) were associated comorbidities with in-hospital mortality. In adults, obesity (OR 1.69, 95% CI, 1.49–1.92), kidney disease (OR, 2.91; 95% CI, 2.23–3.81), chronic neurological disease (OR, 1.67; 95% CI, 1.05–2.66), immunodeficiencies (OR, 2.55; 95% CI, 1.53–4.23) and cancer (OR, 2.93; 95% CI, 2.12–4.04) were associated comorbidities. In older patients, obesity (OR, 1.47; 95% CI=1.27 - 1.71), kidney disease (OR, 1.30; 95% CI=1.08 – 1.55), chronic neurological disease (OR, 1.37; 95% CI=1.06 – 1.77), and cancer (OR, 1.49; 95% CI, 1.13–1.74), chronic lung disease (OR, 1.29; 95% CI=1.06–1.57) and liver disease (OR, 1.55; 95% CI, 1.08–2.21) were associated comorbidities. Interpretation: Common and different associated comorbidities with COVID-19 in-hospital mortality may exist among age groups. Independently of the age, individuals with kidney, chronic neurologic, and cancer would be a high risk of died. The risk of in-hospital mortality associated with comorbidities may be higher in 18-29 patients compare to older.Funding: This research team is supported by the regular budget of National Center for Epidemiology, Disease Prevention and Control (CDC Peru). The funders had no role in this work and decision to submit for publication.Declaration of Interest: All authors work at the National Center for Epidemiology, Prevention and Disease Control of the Peruvian Ministry of Health (CDC-MINSA). However, the views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the CDC Peru, Peruvian Ministry of Health, nor the Peruvian Government. No other disclosures are reported.Ethical Approval: No ethical approval was required as the study analyzed only secondary anonymous surveillance data.