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Meta-Analysis
. 2021;50(2):132-140.
doi: 10.1159/000513288. Epub 2021 Feb 2.

The Association between Presence of Comorbidities and COVID-19 Severity: A Systematic Review and Meta-Analysis

Maryam Honardoost  1   2 , Laila Janani  3 , Rokhsareh Aghili  1 , Zahra Emami  1 , Mohammad E Khamseh  4
Affiliations
Meta-Analysis

The Association between Presence of Comorbidities and COVID-19 Severity: A Systematic Review and Meta-Analysis

Maryam Honardoost et al. Cerebrovasc Dis. 2021.

Abstract

Aim: Several studies reported the accompaniment of severe COVID-19 with comorbidities. However, there is not a systematic evaluation of all aspects of this association. Therefore, this meta-analysis aimed to assess the association between all underlying comorbidities in COVID-19 infection severity.

Methods: Electronic literature search was performed via scientific search engines. After the removal of duplicates and selection of articles of interest, 28 studies were included. A fixed-effects model was used; however, if heterogeneity was high (I2 > 50%) a random-effects model was applied to combine the data.

Results: A total of 6,270 individuals were assessed (1,615 severe and 4,655 non-severe patients). The median age was 63 (95% confidence interval [CI]: 49-74) and 47 (95% CI: 19-63) years in the severe and non-severe groups, respectively. Moreover, about 41% of patients had comorbidities. Severity was higher in patients with a history of cerebrovascular disease: OR 4.85 (95% CI: 3.11-7.57). The odds of being in a severe group increase by 4.81 (95% CI: 3.43-6.74) for a history of cardiovascular disease (CVD). This was 4.19 (95% CI: 2.84-6.19) for chronic lung disease and 3.18, 95% CI: 2.09-4.82 for cancer. The odds ratios of diabetes and hypertension were 2.61 (95% CI: 2.02-3.3) and 2.37 (95% CI: 1.80-3.13), respectively.

Conclusions: The presence of comorbidities is associated with severity of COVID-19 infection. The strongest association was observed for cerebrovascular disease, followed by CVD, chronic lung disease, cancer, diabetes, and hypertension.

Keywords: COVID-19; Cardiovascular disorders; Cerebrovasular disease; Comorbid conditions; Disease severity.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Flowchart of literature search and article selection.
Fig. 2
Fig. 2
Pooled prevalence of comorbidities in included studies. CVD, cardiovascular disease.
Fig. 3
Fig. 3
Prevalence of comorbid conditions among patients with severe COVID-19 compared with non-severe patients. CVD, cardiovascular disease; OR, odds ratio; CI, confidence interval.
Fig. 4
Fig. 4
Funnel plot for meta-analysis of the prevalence of comorbidity in COVID-19 patients. OR, odds ratio.
See this image and copyright information in PMC

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