A systematic review and meta-analysis of geographic differences in comorbidities and associated severity and mortality among individuals with COVID-19

Thakur, Bhaskar; Dubey, Pallavi; Benitez, Joseph; Torres, Joshua P.; Reddy, Sireesha; Shokar, Navkiran K.; Aung, KoKo; Mukherjee, Debabrata; Dwivedi, Alok

doi:10.1038/s41598-021-88130-w

Cited by 235 publications

(249 citation statements)

References 55 publications

(40 reference statements)

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“…Evidence was weakest for hypertension as an independent risk factor for severe outcomes. Two similar reviews that were published whilst our rapid review was under peer reviewand included some more recent studies -found similar results (33,34), although another found no association with obesity in meta-analysis (33)(34)(35).…”

Section: Summary Of Findingsmentioning

confidence: 60%

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Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic

Mason

Maudsley

McHale

et al. 2021

Front. Public Health

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Objectives: Early in the COVID-19 pandemic, people with underlying comorbidities were overrepresented in hospitalised cases of COVID-19, but the relationship between comorbidity and COVID-19 outcomes was complicated by potential confounding by age. This review therefore sought to characterise the international evidence base available in the early stages of the pandemic on the association between comorbidities and progression to severe disease, critical care, or death, after accounting for age, among hospitalised patients with COVID-19.Methods: We conducted a rapid, comprehensive review of the literature (to 14 May 2020), to assess the international evidence on the age-adjusted association between comorbidities and severe COVID-19 progression or death, among hospitalised COVID-19 patients – the only population for whom studies were available at that time.Results: After screening 1,100 studies, we identified 14 eligible for inclusion. Overall, evidence for obesity and cancer increasing risk of severe disease or death was most consistent. Most studies found that having at least one of obesity, diabetes mellitus, hypertension, heart disease, cancer, or chronic lung disease was significantly associated with worse outcomes following hospitalisation. Associations were more consistent for mortality than other outcomes. Increasing numbers of comorbidities and obesity both showed a dose-response relationship. Quality and reporting were suboptimal in these rapidly conducted studies, and there was a clear need for additional studies using population-based samples.Conclusions: This review summarises the most robust evidence on this topic that was available in the first few months of the pandemic. It was clear at this early stage that COVID-19 would go on to exacerbate existing health inequalities unless actions were taken to reduce pre-existing vulnerabilities and target control measures to protect groups with chronic health conditions.

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Section: Summary Of Findingsmentioning

confidence: 60%

“…Furthermore, patients in many studies had not yet reached their clinical endpoint. We now also note that similar reviews were published while ours was under peer review, and are also primarily focused on samples of hospitalised patients [e.g., (33)(34)(35)].…”

Section: Strengths and Limitations Of The Evidence Basementioning

confidence: 96%

Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic

Mason

Maudsley

McHale

et al. 2021

Front. Public Health

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“…Die häufigsten Komorbiditäten waren Depression/Angst (42 %) und Autoimmunerkrankungen (16 %). Die häufigsten neurologischen Manifestationen waren Benommenheit (81 %), Kopfschmerzen (68 %), Taubheitsgefühl/Kribbeln (60 %), Dysgeusie (59 %), Anosmie (55 %) und Myalgien (55 %), Schwindel (47 %), Schmerzen (43 %), verschwommenes Sehen (30 %) und Tinnitus (29 %), 85 % litten unter Müdigkeit [ 46 ].…”

Section: Langzeitfolgenunclassified

COVID-19: neurologische Manifestationen – Update

2021

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Die COVID-19-Infektion kann sich über das pulmonale Erscheinungsbild hinaus mit einer Vielzahl an sowohl akuten als auch chronischen neurologischen und neuropsychiatrischen (Begleit‑)Symptomen und Erkrankungen manifestieren. Unspezifische Symptome wie Kopfschmerzen, Müdigkeit, Geruchs- und Geschmacksstörung wurden häufiger, schwere Erkrankungen wie Enzephalopathie, Enzephalitis und zerebrovaskuläre Ereignisse verhältnismäßig selten berichtet. Die Heterogenität der neurologischen und neuropsychiatrischen Erscheinungsbilder ist groß, wie auch die Bandbreite der aufgezeichneten Prävalenzen in den einzelnen Studien. Höheres Patientenalter, vorbestehende neurologische und nichtneurologische Komorbiditäten sowie eine schwere COVID-19-Erkrankung waren assoziiert mit einem erhöhten Risiko für schwere neurologische Komplikationen und eine höhere Krankenhausmortalität. Wahrscheinliche neurotrope Pathomechanismen des SARS-CoV‑2 wurden diskutiert, eine darüber hinausgehende multifaktorielle Genese der neurologisch/neuropsychiatrischen Symptome und Erkrankungen ist jedoch wahrscheinlich.

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“…According to a systematic review, the most prevalent associated diseases are hypertension (32%), obesity (25%), diabetes (18%), and cardiovascular disease (16%), whereas COVID-19 patients with chronic kidney or other renal diseases (51%, 44%), cerebrovascular accident (43%, 44%), and cardiovascular disease (44%, 40%) had more severity and mortality respectively. Additionally, substantial variation in the prevalence of comorbidities and associated disease severity and mortality in different geographic regions was observed, with the highest mortality in Latin American and European patients with any medical condition, mostly male older adults ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Comorbidities predict 30-day hospital mortality of older adults with COVID-19

Pott-Júnior

Cominetti

2021

Geriatric Nursing

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We evaluated whether comorbidities predict disease severity and mortality in a cohort of 147 older adults with COVID-19. Patients were divided into three groups according to the Charlson Comorbidity Index (CCI) score. Groups 2 (CCI 4 – 5) and 3 (CCI ≥ 6) had higher 30-day mortality rate as compared to group 1 (CCI ≤ 3). Cox regression showed that even after adding sex, National Early Warning Score (NEWS) 2 score and the need for intensive care unit admission to the model, no significant changes were found in the mortality risk predicted by the CCI score, showing that chronic pathologies are key determinants of short-term survival in COVID-19. This work is important for the geriatric nursing field as it demonstrates that alternative approaches for clinical decision-making that consider the comorbidities, rather than only chronological age, can be especially significant for the management of COVID-19 patients’ hospitalization.

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A systematic review and meta-analysis of geographic differences in comorbidities and associated severity and mortality among individuals with COVID-19

Cited by 235 publications

References 55 publications

Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic

Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic

COVID-19: neurologische Manifestationen – Update

Comorbidities predict 30-day hospital mortality of older adults with COVID-19

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