An Ecologic Analysis of Comorbidities in Patients with COVID-19 in Philadelphia and New York City

Objective: Early scientific reports of the COVID-19 pandemic suggested that the coronavirus was associated with more serious disease and mortality in older adults. However, additional research suggested that those with underlying comorbidities, including obesity, type 2 diabetes, heart and respiratory diseases were most at risk for more severe outcomes. As a result, most studies focused on comorbidities among those who were hospitalized or critically ill. There is a need to understand how common comorbidities are associated with overall risk of infection. This analysis aimed to explore the relationship between COVID-19 infection and common comorbidities. Methods: An ecologic analysis explored aggregate case counts of COVID-19 cases across zip codes compared to area-level estimates of health-related variables and outcomes in Philadelphia, PA and New York City, NY. Results: The analysis found that small area-estimated rates of obesity and asthma were significant ecologic predictors of population-based rates of COVID-19 cases in New York City. In contrast, small area-estimates rates of arthritis were significant predictors in Philadelphia. Conclusions: There are important area-level variations in COVID-19 infections that are correlated with variations in other chronic conditions, suggesting that factors that influence health disparities may affect the distribution of COVID-19.