Faculty of Medicine

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    Comorbid Conditions in a Cohort of Inpatients with SARS-CoV-2 and their Association with In-Hospital Mortality During the Early Phases of the Pandemic
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2023-12-01)
    ;
    Cibrev, Dragan
    ;
    ;
    Chamurovski, Nikola
    ;
    Introduction: Studies determined that age and associated comorbidities are associated with worse outcomes for COVID-19 patients. The aim of the present study is to examine previous electronic health records of SARS-CoV-2 patients to identify which chronic conditions are associated with in-hospital mortality in a nationally representative sample. Materials and Methods: The actual study is a cross-sectional analysis of SARS-CoV-2 infected patients who were treated in repurposed hospitals. The study includes a cohort of patients treated from 06-11-2020 to 15-03-2021 for COVID-19 associated pneumonia. To examine the presence of comorbidities, electronic health records were examined and analyzed. Results: A total of 1486 in-patients were treated in the specified period, out of which 1237 met the criteria for case. The median age of the sample was 65 years. The overall in-hospital mortality in the sample was 25.5%, while the median length of stay was 11 days. From whole sample, 16.0% of the patients did not have established diagnoses in their electronic records, while the most prevalent coexisting condition was arterial hypertension (62.7%), followed by diabetes mellitus (27.3%). The factors of age, male gender, and the number of diagnoses showed a statistically significant increase in odds ratio (OR) for in-hospital mortality. The presence of chronic kidney injury was associated with the highest increase of OR (by 3.37) for in-hospital mortality in our sample. Conclusion: The study reaffirms the findings that age, male gender, and the presence of comorbidities are associated with in-hospital mortality in COVID-19 treated and unvaccinated patients. Our study suggests that chronic kidney injury showed strongest association with the outcome, when adjusted for age, gender, and coexisting comorbidities.
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    The burden of chronic respiratory diseases in Macedonia
    (2018)
    Aim: Chronic respiratory diseases involve a heterogeneous group of disease, including, COPD, asthma, sleep apnea syndrome, pulmonary hypertension and many occupational diseases. This study aims to estimate the burden of chronic respiratory diseases (CRDs) and 10-year mortality trend compared to other non-communicable diseases in Macedonia. Material and Methods: Data was retrieved from official reports by State Statistical Office, annual reports of the Health Insurance Fund, the burden of disease estimates by WHO Global Health Observatory data as well as the Institute for Health Metrics and Evaluation (IHME). Analytical and descriptive methods were used to present the results. Results: A total of 4 886 deaths due to chronic respiratory diseases were recorded in a 10-year period from 2007 to 2017 or 3% of total deaths in Macedonia, making it the 5th leading cause of death. The mortality rate increased from 18, 35 deaths per 100.000 population in 2007 to 30, 64 in 2017. Chronic respiratory diseases related Disability Adjusted Life-Year (DALYs) burden of approximately of 728.72 per 100.000 or rank 9 at the leading causes for disability and premature mortality. In Macedonia COPD is in the top 15 leading causes due to premature mortality, with an estimated burden of 504.84 DALYs per 100.000. Highest risk factors related burden was attributed to the environment and smoking. Conclusion: Although they are preventable, chronic respiratory diseases are in the top 10 leading causes for mortality and disability in Macedonia, with a projection to increase as air-pollution and smoking rates are still high and the population ages. The lack of epidemiological data, national guidelines for treatment and management allows these diseases to be on the rise, as effective policy and strategy is very much needed.