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Meta-Analysis
. 2020 Dec 9:1-12.
doi: 10.1159/000512592. Online ahead of print.

Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

Mohitosh Biswas  1 , Shawonur Rahaman  2 , Tapash Kumar Biswas  3 , Zahirul Haque  4 , Baharudin Ibrahim  5
Affiliations
Meta-Analysis

Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

Mohitosh Biswas et al. Intervirology. .

Abstract

Introduction: Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients.

Methods: Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as p < 0.05.

Results: COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67-2.07; p < 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age <50 years (RR 15.44: 95% CI 13.02-18.31; p < 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04-7.88; p < 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39-6.76; p < 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20-4.25; p < 0.00001), respiratory disease (RR 2.74: 95% CI 2.04-3.67; p < 0.00001), diabetes (RR 1.97: 95% CI 1.48-2.64; p < 0.00001), hypertension (RR 1.95: 95% CI 1.58-2.40; p < 0.00001), and cancer (RR 1.89; 95% CI 1.25-2.84; p = 0.002) but not liver disease (RR 1.64: 95% CI 0.82-3.28; p= 0.16).

Conclusion: Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.

Keywords: Coronavirus disease-2019; Demographic characteristics; Risk of mortality; Severe acute respiratory syndrome coronavirus-2.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flowchart for identifying studies for this systematic review and meta-analysis. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Fig. 2
Fig. 2
Forest plot of the pooled effects of COVID-19 male patients against female patients on the risk of mortality. M, male; F, female; CI, confidence interval; COVID-19, coronavirus disease-2019.
Fig. 3
Fig. 3
Forest plot of the pooled effects of COVID-19 patients with age ≥50 years against patients with age <50 years on the risk of mortality. Decre, decrease; Incre, increase; CI, confidence interval; COVID-19, coronavirus disease-2019.
Fig. 4
Fig. 4
a Forest plot of the pooled effects of comorbidities on the risk of mortality associated with hypertension, diabetes or respiratory disease. b Forest plot of the pooled effects of comorbidities on the risk of mortality associated with cardiovascular or cereborovascular disease. c Forest plot of the pooled effects of comorbidities on the risk of mortality associated with kidney disease, liver disease, or cancer. Incre, increase; CI, confidence interval.
Fig. 5
Fig. 5
Funnel plot for detection of publication bias as determined by Egger's test. a Funnel plot for COVID-19 patients positive for SARS-CoV-2 test. b Funnel plot for COVID-19-hypertensive patients and risk for mortality. COVID-19, coronavirus disease-2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2.
See this image and copyright information in PMC

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