Prevalence of comorbidity in Chinese patients with COVID-19: systematic review and meta-analysis of risk factors

• Published in: BMC infectious diseases 2021-02, Vol.21 (1), p.200-200, Article 200
• Main Authors: Yin, Tingxuan, Li, Yuanjun, Ying, Ying, Luo, Zhijun
• Format: Article
• Language: English
• Subjects: Bias; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cerebrovascular diseases; Cerebrovascular Disorders - epidemiology; China - epidemiology; Chronic obstructive pulmonary disease; Comorbidity; Coronaviruses; Cough; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; Diabetes mellitus; Diabetes Mellitus - epidemiology; Disease transmission; Dyspnea; Evaluation; Fever; Forecasts and trends; Health risk assessment; Health risks; Humans; Hypertension; Infections; Infectious diseases; Kidney diseases; Liver diseases; Lung diseases; Malignancy; Management; Medical prognosis; Meta-analysis; Mortality; Neoplasms - epidemiology; Normal distribution; Obstructive lung disease; Pandemics; Patients; Population; Public health; Pulmonary Disease, Chronic Obstructive - epidemiology; Renal Insufficiency, Chronic - epidemiology; Respiratory diseases; Respiratory distress syndrome; Risk analysis; Risk Factors; Risk groups; SARS-CoV-2; Secondary data analysis; Severe acute respiratory syndrome coronavirus 2; Subgroups; Systematic review; Viral diseases
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-021-05915-0

Coronavirus disease 2019 (COVID-19) is an infectious disease characterized by cough, fever, and fatigue and 20% of cases will develop into severe conditions resulting from acute lung injury with the manifestation of the acute respiratory distress syndrome (ARDS) that accounts for more than 50% of mortality. Currently, it has been reported that some comorbidities are linked with an increased rate of severity and mortality among COVID-19 patients. To assess the role of comorbidity in COVID-19 progression, we performed a systematic review with a meta-analysis on the relationship of COVID-19 severity with 8 different underlying diseases. PubMed, Web of Science, and CNKI were searched for articles investigating the prevalence of comorbidities in severe and non-severe COVID-19 patients. A total of 41 studies comprising 12,526 patients were included. Prevalence of some commodities was lower than that in general population such as hypertension (19% vs 23.2%), diabetes (9% vs 10.9%), chronic kidney disease (CKD) (2% vs 9.5%), chronic liver diseases (CLD) (3% vs 24.8%) and chronic obstructive pulmonary disease (COPD) (3% vs 8.6%), while some others including cancer (1% vs 0.6%), cardiovascular disease (6% vs 1.8%) and cerebrovascular disease (2% vs 0.9%) exhibited greater percentage in COVID-19. Cerebrovascular disease (OR = 3.70, 95%CI 2.51-5.45) was found to be the strongest risk factor in disease exacerbation, followed by CKD (OR = 3.60, 95%CI 2.18-5.94), COPD (OR = 3.14, 95% CI 2.35-4.19), cardiovascular disease (OR = 2.76, 95% CI 2.18-3.49), malignancy (OR = 2.63, 95% CI 1.75-3.95), diabetes (OR = 2.49, 95% CI 2.10-2.96) and hypertension (OR = 2.13, 95% CI 1.81-2.51). We found no correlation between CLD and increased disease severity (OR = 1.32, 95% CI 0.96-1.82). The impact of all eight underlying diseases on COVID-19 deterioration seemed to be higher in patients outside Hubei. Based on different comorbidities, COVID-19 patients tend to be at risk of developing poor outcomes to a varying degree. Thus, tailored infection prevention and monitoring and treatment strategies targeting these high-risk subgroups might improve prognosis during the COVID-19 pandemic.