Physiological Burden of Cardiometabolic and Respiratory Comorbidities in Patients with SARI-Related Symptoms: A Cross-Sectional Analysis of Diabetes Mellitus, Documented Heart Failure, Bronchial Asthma, Age, Sex, and Symptom Phenotypes

Abstract

Background: The physiological state can modify disease expression and burden for many respiratory syndromes. Severe acute respiratory infection (SARI) is one of these syndromes. The presence of chronic respiratory and cardiometabolic conditions can alter the immune response and increase the host's vulnerability to respiratory infection. This study aimed to identify the distribution of SARI symptom-related phenotypes and to assess the degree of their association with bronchial asthma; chronic obstructive pulmonary disease; diabetes mellitus; documented heart failure; and coronary heart disease by age, gender, and multimorbidity burden. Methods: A cross-sectional study analyzed 222 twin-sampling clinical records for chronic diseases and SARI symptoms. The description and classification of symptoms were standardized using binary indicators and were classified as fever, cough, or cough and fever. Statistical analyses were performed to assess the associations with the symptom phenotypes. Results: The average age of the study population was 52.8 +/- 23.4 years, and 53.2% were women. The most frequent symptoms were cough and fever, which were found in 199 (89.6%) of study participants. Diabetes mellitus and heart failure were the most frequent chronic diseases, and the most frequent overlap was 142 (64%) with diabetes mellitus and documented heart failure. Bronchial asthma was inversely associated with the cough-and-fever symptom (adjusted OR 0.22, 95% CI 0.08 - 0.62; p = 0.004). The relationship between age and the count of comorbidities was positive (Spearman rho = 0.304; p < 0.001), and there was no relationship between age and the cough and fever symptoms.