Clinical Characteristics and Risk Factors for Fatality and Severity in Patients with Coronavirus Disease in Korea: A Nationwide Population-Based Retrospective Study Using the Korean Health Insurance Review and Assessment Service (HIRA) Database

Int J Environ Res Public Health. 2020 Nov 18;17(22):8559. doi: 10.3390/ijerph17228559.


Background: We aimed to investigate the clinical characteristics and risk factors for fatality and severity in these patients.

Methods: In this nationwide population-based retrospective study, we investigated the data of 7339 laboratory-confirmed COVID-19 patients, aged ≥ 18 years, using the Korean Health Insurance Review and Assessment Service (HIRA) database. Comorbidities and medications used were identified using HIRA codes, and severe COVID-19 was defined as that requiring oxygen therapy, mechanical ventilator, cardiopulmonary resuscitation, or extracorporeal membrane oxygenation. The outcomes were death due to COVID-19 and COVID-19 severity.

Results: Mean patient age was 47.1 years; 2970 (40.1%) patients were male. Lopinavir/ritonavir, hydroxychloroquine, antibiotics, ribavirin, oseltamivir, and interferon were administered to 35.8%, 28.4%, 38.1%, 0.1%, 0.3%, and 0.9% of patients, respectively. After adjusting for confounding factors, diabetes mellitus, chronic kidney disease, previous history of pneumonia, aging, and male were significantly associated with increased risk of death and severe disease. No medication was associated with a reduced risk of fatality and disease severity.

Conclusions: We found several risk factors for fatality and severity in COVID-19 patients. As the drugs currently used for COVID-19 treatment have not shown significant efficacy, all efforts should be made to develop effective therapeutic modalities for COVID-19.

Keywords: comorbidity; coronavirus; death; pandemic; prognosis.

MeSH terms

  • Betacoronavirus
  • COVID-19
  • COVID-19 Drug Treatment
  • Comorbidity
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / pathology*
  • Female
  • Humans
  • Insurance, Health*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / pathology*
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2