Understanding the relationships between pre-existing conditions and complications of COVID-19 infection is critical to identifying which patients will develop severe disease. Here, we leverage ~1.1 million clinical notes from 1803 hospitalized COVID-19 patients and deep neural network models to characterize associations between 21 pre-existing conditions and the development of 20 complications (e.g. respiratory, cardiovascular, renal, and hematologic) of COVID-19 infection throughout the course of infection (i.e. 0–30 days, 31–60 days, and 61–90 days). Pleural effusion was the most frequent complication of early COVID-19 infection (89/1803 patients, 4.9%) followed by cardiac arrhythmia (45/1803 patients, 2.5%). Notably, hypertension was the most significant risk factor associated with 10 different complications including acute respiratory distress syndrome, cardiac arrhythmia, and anemia. The onset of new complications after 30 days is rare and most commonly involves pleural effusion (31–60 days: 11 patients, 61–90 days: 9 patients). Lastly, comparing the rates of complications with a propensity-matched COVID-negative hospitalized population confirmed the importance of hypertension as a risk factor for early-onset complications. Overall, the associations between pre-COVID conditions and COVID-associated complications presented here may form the basis for the development of risk assessment scores to guide clinical care pathways.

了解既存状况与 COVID-19 感染并发症之间的关系对于确定哪些患者会发展为严重疾病至关重要。在这里，我们利用来自 1803 名住院 COVID-19 患者的约 110 万临床记录和深度神经网络模型来表征 21 种既存状况与 COVID-20 并发症（例如呼吸系统、心血管系统、肾脏和血液系统）的发展之间的关联。 19 在整个感染过程中（即 0-30 天、31-60 天和 61-90 天）感染。胸腔积液是早期 COVID-19 感染最常见的并发症（89/1803 例患者，4.9%），其次是心律失常（45/1803 例患者，2.5%）。尤其，高血压是与 10 种不同并发症相关的最重要危险因素，包括急性呼吸窘迫综合征、心律失常和贫血。30 天后出现新的并发症很少见，最常见的是胸腔积液（31-60 天：11 名患者，61-90 天：9 名患者）。最后，将并发症发生率与倾向匹配的 COVID 阴性住院人群进行比较，证实了高血压作为早发并发症危险因素的重要性。总体而言，此处介绍的 COVID 前病症与 COVID 相关并发症之间的关联可能构成制定风险评估评分以指导临床护理途径的基础。30 天后出现新的并发症很少见，最常见的是胸腔积液（31-60 天：11 名患者，61-90 天：9 名患者）。最后，将并发症发生率与倾向匹配的 COVID 阴性住院人群进行比较，证实了高血压作为早发并发症危险因素的重要性。总体而言，此处介绍的 COVID 前病症与 COVID 相关并发症之间的关联可能构成制定风险评估评分以指导临床护理途径的基础。30 天后出现新的并发症很少见，最常见的是胸腔积液（31-60 天：11 名患者，61-90 天：9 名患者）。最后，将并发症发生率与倾向匹配的 COVID 阴性住院人群进行比较，证实了高血压作为早发并发症危险因素的重要性。总体而言，此处介绍的 COVID 前病症与 COVID 相关并发症之间的关联可能构成制定风险评估评分以指导临床护理途径的基础。