Underlying diseases might be risk factors for poor prognosis in patients with coronavirus disease (
COVID-19); however, we still do not know whether these diseases are independent factors affecting prognosis, which type of underlying diseases are risk factors, and which type of clinical outcomes are affected. We retrospectively reviewed cohort data from 7,590 de-identified patients with
COVID-19 who were diagnosed using severe acute respiratory syndrome-coronavirus-2
RNA polymerase chain reaction test up to May 15, 2020. We used linked-medical claims data provided by the Health Insurance Review and Assessment Service in South Korea. Underlying diseases were identified using the diagnostic codes in the patients' files from January 1, 2019 to December 31, 2019. The total mortality rate was 3.0% in patients with
COVID-19. After adjusting for age, sex, and concomitant
chronic conditions, we found that
congestive heart failure, chronic
pulmonary diseases, diabetes without chronic complications, renal diseases, and
malignancy were factors that significantly increased the cost of treatment.
Cerebrovascular disease, chronic
pulmonary disease, and
paralysis were found to be independent factors significant in prolonging
hospital stay. Diabetes with chronic complications was independently associated with intensive care unit admission. In addition, underlying
congestive heart failure (odds ratio [OR], 1.724; P = 0.003),
dementia (OR, 1.598; P = 0.012), diabetes with and without chronic complications (OR, 1.821; P = 0.002 and OR, 1.518; P = 0.022, respectively), renal disease (OR, 2.299; P = 0.002), and
malignancy (OR, 1.529; P = 0.039) were significant factors associated with death, even after adjustments. Underlying diseases were significant independent factors of the poor prognosis in patients with
COVID-19. The effects were variable according to the type of underlying disease and clinical outcome. Therefore, patients with
COVID-19 with underlying diseases should be monitored more closely because they are more at risk of a poor prognosis.