The influence of comorbidity on the severity of COVID-19 disease: systematic review and analysis

Zaki, N.; Mohamed, E. A.; Ibrahim, S.; Khan, G.

A novel form of coronavirus disease (SARS-CoV-2) has spread rapidly across the world. This disease, originating in Wuhan, China, has become a global pandemic. What risk factors influence the severity of the disease is of considerable importance. This research is intended to offer a systematic review/meta-analysis for assessing how common clinical conditions and comorbidities correlate with COVID-19. The meta-analysis incorporated seven studies covering 4101 COVID-19 patients from Chinese hospitals who had their diagnosis confirmed through laboratory testing. The findings demonstrate that the most common comorbidities with the disease were COPD (2.53%, OR 3.24 [95% CI: 1.99-4.45], p< 0.0006), cardiovascular disease (10.76%, OR 2.89 [95% CI: 1.90-4.40], p <0.0001), coronary heart disease (5.52%, OR 2.97 [95% CI: 1.99-4.45], p <0.0001), diabetes (11.34%, OR 2.27, [95% CI: 1.46-3.53], p = 0.0003), and hypertension (22.07%, OR 2.43 [95% CI: 1.71-3.45], p <0.0001). No significant associations were found for disease severity with the comorbidities of kidney disease, liver disease, or cancer. The most frequently exhibited clinical symptoms were fever (74.52%, OR 1.37, 95% CI: 1.01-1.86, p = 0.04), cough (62.15%, OR 1.25, 95% CI: 0.97-1.60, p = 0.0823), myalgia/fatigue (38.77%, OR 1.31, 95% CI: 1.11-1.55, p = 0.0018), dyspnea (33.9%, OR 3.61, 95% CI: 2.57-5.06, p = <0.0001), respiratory failure/ARDS (20.6%, OR 11.46, 95% CI: 3.24-40.56, p = 0.0002), diarrhea (11.21%) and chest tightness/pain (16.82%, OR 2.17, 95% CI: 1.40-3.36, p = 0.0006). Meta-analysis also revealed that neither the duration of the incubation period nor current smoking status associated with disease severity.