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Meta-Analysis
. 2021 Feb 16;16(2):e0246190.
doi: 10.1371/journal.pone.0246190. eCollection 2021.

The prognostic value of comorbidity for the severity of COVID-19: A systematic review and meta-analysis study

Mobina Fathi  1 , Kimia Vakili  1 , Fatemeh Sayehmiri  2 , Ashraf Mohamadkhani  3 , Mohammadreza Hajiesmaeili  4 , Mostafa Rezaei-Tavirani  5 , Owrang Eilami  6
Affiliations
Meta-Analysis

The prognostic value of comorbidity for the severity of COVID-19: A systematic review and meta-analysis study

Mobina Fathi et al. PLoS One. .

Abstract

Background and objectives: With the increase in the number of COVID-19 infections, the global health apparatus is facing insufficient resources. The main objective of the current study is to provide additional data regarding the clinical characteristics of the patients diagnosed with COVID-19, and in particular to analyze the factors associated with disease severity, lack of improvement, and mortality.

Methods: 102 studies were included in the present meta-analysis, all of which were published before September 24, 2020. The studies were found by searching a number of databases, including Scopus, MEDLINE, Web of Science, and Embase. We performed a thorough search from early February until September 24. The selected papers were evaluated and analyzed using Stata software application version 14.

Results: Ultimately, 102 papers were selected for this meta- analysis, covering 121,437 infected patients. The mean age of the patients was 58.42 years. The results indicate a prevalence of 79.26% for fever (95% CI: 74.98-83.26; I2 = 97.35%), 60.70% for cough (95% CI: 56.91-64.43; I2 = 94.98%), 33.21% for fatigue or myalgia (95% CI: 28.86-37.70; I2 = 96.12%), 31.30% for dyspnea (95% CI: 26.14-36.69; I2 = 97.67%), and 10.65% for diarrhea (95% CI: 8.26-13.27; I2 = 94.20%). The prevalence for the most common comorbidities was 28.30% for hypertension (95% CI: 23.66-33.18; I2 = 99.58%), 14.29% for diabetes (95% CI: 11.88-16.87; I2 = 99.10%), 12.30% for cardiovascular diseases (95% CI: 9.59-15.27; I2 = 99.33%), and 5.19% for chronic kidney disease (95% CI: 3.95-6.58; I2 = 96.42%).

Conclusions: We evaluated the prevalence of some of the most important comorbidities in COVID-19 patients, indicating that some underlying disorders, including hypertension, diabetes, cardiovascular diseases, and chronic kidney disease, can be considered as risk factors for patients with COVID-19 infection. Furthermore, the results show that an elderly male with underlying diseases is more likely to have severe COVID-19.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow diagram.
Fig 2
Fig 2. Forest Plot of the prevalence of hypertension in COVID-19 patients.
Each square indicates the effect estimate of individual articles with their 95% CI Size of squares is proportional to the weight of each paper in the meta-analysis. In this plot, papers are indicated in the order of first author’s names and publication date (based on a random effects model).
Fig 3
Fig 3. Forest Plot of the prevalence of diabetes in COVID-19 patients.
Each square indicates the effect estimate of individual articles with their 95% CI Size of squares is proportional to the weight of each paper in the meta-analysis. In this plot, papers are indicated in the order of first author’s names and publication date (based on a random effects model).
Fig 4
Fig 4. Forest Plot of the prevalence of cardiovascular diseases in COVID-19 patients.
Each square indicates the effect estimate of individual articles with their 95% CI Size of squares is proportional to the weight of each paper in the meta-analysis. In this plot, papers are indicated in the order of first author’s names and publication date (based on a random effects model).
Fig 5
Fig 5. Begg’s funnel plot for publication bias.
Fig 6
Fig 6. The association between prevalence of risk factors for COVID-19 and sample size, using Meta regression.
See this image and copyright information in PMC

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