Comorbidities' potential impacts on severe and non-severe patients with COVID-19: A systematic review and meta-analysis

Medicine (Baltimore). 2021 Mar 26;100(12):e24971. doi: 10.1097/MD.0000000000024971.

Abstract

Background: An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus (SARS-CoV-2) emerged in December 2019 in Wuhan, China. Epidemiologic evidence suggests that patients with comorbidities and novel coronavirus disease 2019 (COVID-19) infection may have poor survival outcomes. However, the risk of these coexisting medical conditions in severe and non-severe cases has not been systematically reported.

Purpose: The present study aimed to estimate the association of chronic comorbidities in severe and non-severe cases.

Methods: A literature search was conducted using the databases PubMed, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang Database, Chinese Scientific Journals Full-text Database (CQVIP) from the inception dates to April 1, 2020, to identify cohort studies assessing comorbidity and risk of adverse outcome. Either a fixed- or random-effects model was used to calculate the overall combined risk estimates.

Results: A total of 22 studies involving 3286 patients with laboratory-confirmed COVID-19 were included in the analysis. Overall, compared with the patients with non-severe cases, the pooled odds ratios (ORs) of hypertension, diabetes mellitus, and cardiovascular, cerebrovascular, and respiratory diseases in patients with severe cases were 2.79 (95% confidence intervals [95% CI]: 1.66-4.69), 1.64 (95% CI: 2.30-1.08), 1.79 (95% CI: 1.08-2.96), 3.92 (95% CI: 2.45-6.28), and 1.98 (95% CI: 1.26-3.12), respectively.

Conclusions: This meta-analysis supports the finding that chronic comorbidities may contribute to severe outcome in patients with COVID-19. According to the findings of the present study, old age and 2 or more comorbidities are significantly impactful to COVID-19 outcomes in hospitalized patients in China.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Age Factors
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • Cardiovascular Diseases / epidemiology
  • Cerebrovascular Disorders / epidemiology
  • Chronic Disease
  • Comorbidity*
  • Diabetes Mellitus / epidemiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Respiratory Tract Diseases / epidemiology
  • SARS-CoV-2
  • Severity of Illness Index