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Review
. 2020 Nov;41(11):1165-1174.
doi: 10.15537/smj.2020.11.25454.

Comorbidities and severity of coronavirus disease 2019 patients

Nashwa M Radwan  1 , Nagla E Mahmoud, Amal H Alfaifi, Khaled I Alabdulkareem
Affiliations
Review

Comorbidities and severity of coronavirus disease 2019 patients

Nashwa M Radwan et al. Saudi Med J. 2020 Nov.

Abstract

Objectives: To determine the association between comorbidities and the severity of the disease among COVID-19 patients.

Methods: We searched the Cochrane, Medline, Trip, and EMBASE databases from 2019. The review included all available studies of COVID-19 patients published in the English language and studied the clinical characteristics, comorbidities, and disease outcomes from the beginning of the pandemic. Two authors extracted studies characteristics and the risk of bias. Odds ratio (OR) was used to analyze the data with 95% confidence interval (CI).

Results: The review included 1,885 COVID-19 patients from 7 observational studies with some degree of bias risk and substantial heterogeneity. A significant association was recorded between COVID-19 severity and the following variables: male (OR= 1.60, 95%CI= 1.05 - 2.43); current smoker (OR=2.06, 95%CI= 1.08 - 3.94); and the presence of comorbidities including hypertension (OR=2.05, 95%CI= 1.56 - 2.70), diabetes (OR=2.46, 95%CI= 1.53 - 3.96), coronary heart disease (OR=4.10, 95%CI= 2.36 - 7.12), chronic kidney disease (OR=4.06, 95%CI= 1.45 - 11.35), and cancer (OR=2.28, 95%CI= 1.08 - 4.81).

Conclusions: Comorbidities among COVID-19 patients may contribute to increasing their susceptibility to severe illness. The identification of these potential risk factors could help reduce mortality by identifying patients with poor prognosis at an early stage.

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Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Risk of bias among included trials.
Figure 3
Figure 3
Forest plot of background risk factors and severity of COVID-19 among studied participants.
Figure 4
Figure 4
Forest plot of underlying comorbidities and the severity of COVID-19.
Figure 5
Figure 5
Odds ratio and confidence interval of the pooled effect of risk factors for the severity of COVID-19.
See this image and copyright information in PMC

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