Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis

Jing Yang, Ya Zheng, Xi Gou, Ke Pu, Zhaofeng Chen, Qinghong Guo, Rui Ji, Haojia Wang, Yuping Wang, Yongning Zhou, Jing Yang, Ya Zheng, Xi Gou, Ke Pu, Zhaofeng Chen, Qinghong Guo, Rui Ji, Haojia Wang, Yuping Wang, Yongning Zhou

Abstract

Background: An outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, China; the epidemic is more widespread than initially estimated, with cases now confirmed in multiple countries.

Aims: The aim of this meta-analysis was to assess the prevalence of comorbidities in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients and the risk of underlying diseases in severe patients compared to non-severe patients.

Methods: A literature search was conducted using the databases PubMed, EMBASE, and Web of Science through February 25, 2020. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using random-effects models.

Results: Seven studies were included in the meta-analysis, including 1 576 infected patients. The results showed the most prevalent clinical symptom was fever (91.3%, 95% CI: 86-97%), followed by cough (67.7%, 95% CI: 59-76%), fatigue (51.0%, 95% CI: 34-68%) and dyspnea (30.4%, 95% CI: 21-40%). The most prevalent comorbidities were hypertension (21.1%, 95% CI: 13.0-27.2%) and diabetes (9.7%, 95% CI: 7.2-12.2%), followed by cardiovascular disease (8.4%, 95% CI: 3.8-13.8%) and respiratory system disease (1.5%, 95% CI: 0.9-2.1%). When compared between severe and non-severe patients, the pooled OR of hypertension, respiratory system disease, and cardiovascular disease were 2.36 (95% CI: 1.46-3.83), 2.46 (95% CI: 1.76-3.44) and 3.42 (95% CI: 1.88-6.22) respectively.

Conclusion: We assessed the prevalence of comorbidities in the COVID-19 patients and found that underlying disease, including hypertension, respiratory system disease and cardiovascular disease, may be risk factors for severe patients compared with non-severe patients.

Keywords: COVID-19; Clinical characteristics; Comorbidities; Epidemiology; Meta-analysis; SARS-CoV-2.

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1
Figure 1
Flow diagram of the number of studies screened and included in the meta-analysis.
Figure 2
Figure 2
Meta-analysis of the comorbidities in COVID-19 cases. A, B, C, D represent proportions of hypertension, diabetes, respiratory system disease, and cardiovascular disease.
Figure 3
Figure 3
The risk of comorbidities in severe patients compared to non-severe patients. (A) hypertension, (B) diabetes, (C) respiratory system disease, (D) cardiovascular disease.

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Source: PubMed

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