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Meta-Analysis
. 2021 Mar 20;10(1):80.
doi: 10.1186/s13643-021-01636-2.

The effect of age on the incidence of COVID-19 complications: a systematic review and meta-analysis

Sofonyas Abebaw Tiruneh  1 , Zemenu Tadese Tesema  2 , Melkalem Mamuye Azanaw  3 , Dessie Abebaw Angaw  2
Affiliations
Meta-Analysis

The effect of age on the incidence of COVID-19 complications: a systematic review and meta-analysis

Sofonyas Abebaw Tiruneh et al. Syst Rev. .

Abstract

Background: The coronavirus (COVID-19) pandemic was reported from Wuhan, China, on December 31, 2019, and the pandemic was spread to more than 212 countries in the globe. This meta-analysis aimed to assess the pooled incidence of COVID-19 complications and to identify the association between the incidence of complications and age.

Methods: Comprehensive databases, PubMed, Hinari, and Google Scholar, were used to locate potential articles for this review. Data were extracted using Microsoft Excel and imported to the STATA/MP version 16.0 software for analysis. Heterogeneity between studies was assessed using the Cochrane Q test statistics and I2 test, and small study effect was checked using Egger's statistical test at 5% significant level. Sensitivity analysis was checked. A random-effects model was conducted to estimate the pooled incidence of COVID-19 complications. Univariate meta-regression was conducted to identify the association between the mean ages with each complication.

Results: From the total of 1237 studies, 12 studies were included with a total of 3064 COVID-19 patients. The most complications were acute respiratory distress syndrome (30.93%, 95%CI 21.3-40.6%) followed by acute liver injury (22.8%, 95%CI 14-31.5%), shock (10.9%, 95%CI 7.4-14.4%), acute kidney injury (7%, 95%CI 3.8-10.4%), and acute cardiac injury (6.4%, 95%CI 2.8-15.6%). Univariate meta-regression revealed that as the mean age increased by 1 year, the incidence of acute respiratory distress syndrome, acute kidney injury, acute cardiac injury, and shock increased by a factor of 2.9 (β = 2.9, 95%CI 2.4-3.4, adjusted R2 = 88), 0.4 (β = 0.4, 95%CI 0.04-0.72, adjusted R2 = 54), 1.6 (β = 1.6, 95%CI 1.1-2.1, adjusted R2 = 85), and 1.1 (β = 1.1, 95%CI 0.8-1.5, adjusted R2 = 26) times respectively.

Conclusion: Significant complications of COVID-19 viral infections were reported. Older populations were a high-risk group of developing adverse complications as compared to their counterparts. Health care professionals should give primary attention to those risk group individuals.

Keywords: Acute cardiac injury; Acute kidney injury; Acute respiratory distress syndrome; Age; COVID-19; Meta-analysis; Shock.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for included studies for COVID-19 patients
Fig. 2
Fig. 2
Forest plot of pooled incidence of ARDS among hospitalized COVID-19 patients
Fig. 3
Fig. 3
Forest plot of pooled incidence of AKI among hospitalized COVID-19 patients
Fig. 4
Fig. 4
Trim and fill plot of pooled incidence of ACI among hospitalized COVID-19 patients
Fig. 5
Fig. 5
Forest plot of pooled incidence of shock among hospitalized COVID-19 patients
Fig. 6
Fig. 6
Forest plot of pooled incidence of ALI among hospitalized COVID-19 patients
Fig. 7
Fig. 7
The bubble plot of the mean age and ARDS complication among COVID-19 patients
See this image and copyright information in PMC

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