Age-related risk factors and severity of SARS-CoV-2 infection: a systematic review and meta-analysis

J Prev Med Hyg. 2021 Jul 30;62(2):E329-E371. doi: 10.15167/2421-4248/jpmh2021.62.2.1946. eCollection 2021 Jun.

Abstract

Objectives: We aimed to estimate the prevalence of reported symptoms and comorbidities, and investigate the factors associated with age of the SARS-CoV-2 infected patients.

Methods: We performed a systematic review with meta-analysis (PROSPERO registration: CRD42020182677) where the databases (PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer) were searched for clinical studies published from January to April, 2020. Initially, the pooled prevalence of symptoms and comorbidity of COVID-19 patients were estimated using random effect model and the age -related factors were identified performing multivariate analysis [factor analysis].

Results: Twenty-nine articles with 4,884 COVID-19 patients were included in this study. Altogether, we found 33 symptoms and 44 comorbidities where the most frequent 19 symptoms and 11 comorbidities were included in the meta-analysis. The fever (84%), cough/dry cough (61%), and fatigue/weakness (42%) were found more prevalent while acute respiratory distress syndrome, hypertension and diabetes were the most prevalent comorbid condition. The factor analysis showed positive association between a cluster of symptoms and comorbidities with patients' age. The symptoms comprising fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia; and the comorbidities including diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS were the factors positively associated with COVID-19 patient's age.

Conclusion: As an unique effort, this study found a group of symptoms (fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia) and comorbidities (diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS), associated with the age of COVID-19 infected patients.

Keywords: Age-related risk factors; COVID-19 pandemic; Correlation analysis; Symptoms and comorbidities; Systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / mortality*
  • Comorbidity
  • Female
  • Fever / etiology
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Prevalence
  • Risk Factors
  • SARS-CoV-2