Prevalence of co‐morbidities and their association with mortality in patients with <scp>COVID</scp>‐19: A systematic review and meta‐analysis

Singh, Awadhesh Kumar; Gillies, Clare; Singh, Ritu; Singh, Akriti; Chudasama, Yogini; Coles, Briana; Seidu, Samuel; Zaccardi, Francesco; Davies, Melanie J.; Khunti, Kamlesh

doi:10.1111/dom.14124

Cited by 382 publications

(346 citation statements)

References 47 publications

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“…Admittedly, our study had some limitations. Firstly, previous studies have identified some clinical risk factors for the poor prognosis of COVID-19, including older age, male sex, BMI, and the presence of comorbidities [55] , [56] , [57] . It is possible that our conclusions were influenced by these confounding factors due to an inherent limitation of all meta-analyses of observational data.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of liver biochemical parameters for COVID-19 mortality

Lin

Chen²,

Wang

et al. 2021

Annals of Hepatology

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Introduction Coronavirus Disease 2019 (COVID-19) has brought great challenges to global public health. However, a comprehensive analysis of the relationship between liver biochemical parameters and COVID-19 mortality is quite limited. Methods We searched the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, Scopus, Wanfang and China National Knowledge Infrastructure database until May 5, 2020. STATA software was used for the statistical analyses. Results A total of 25 studies involving 5971 COVID-19 patients were included in our analysis. Compared with non-survivors, survivors had lower levels of aspartate aminotransferase (AST) (weighted mean difference [WMD] = -16.71 U/L, 95%CI = [-21.03, -12.40], P < 0.001), alanine transaminase (ALT) (WMD = -5.20U/L, 95%CI = [-8.00, -2.41], P < 0.001), total bilirubin (TBIL) (WMD = 4.40μmol/L, 95%CI = [-5.11, -3.70], P < 0.001) and lactic dehydrogenase (LDH) (WMD = -252.44U/L, 95%CI = [-289.57, -215.30], P < 0.001), and higher albumin (ALB) level (WMD = 4.47 g/L, 95%CI = [3.47, 5.47], P < 0.001). Besides, survivors had lower proportions of these abnormally increased parameters (AST: OR = 0.25, 95%CI = [0.15, 0.41], P < 0.001; ALT: OR = 0.49, 95%CI = [0.37, 0.64], P < 0.001; TBIL: (OR = 0.20, 95%CI = [0.12, 0.34], P < 0.001; LDH, OR = 0.09, 95%CI = [0.06, 0.14], P < 0.001), and lower proportion of abnormally decreased ALB (OR = 0.16, 95%CI = [0.07, 0.38], P < 0.001). Meta-analysis based on standard mean difference and sensitivity analysis did not change the conclusions. Egger test did not detect the presence of publication bias. Conclusions Liver biochemical parameters were strongly correlated with COVID-19 mortality. Measurement of these liver biochemical parameters might assist clinicians to evaluate the prognosis of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of liver biochemical parameters for COVID-19 mortality

Lin

Chen²,

Wang

et al. 2021

Annals of Hepatology

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“…Age, years, median (range) 45 62 11 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) 11 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) Sex, male (%) 10…”

Section: Demographicsunclassified

Distinct antibody responses to SARS-CoV-2 in children and adults across the COVID-19 clinical spectrum

et al. 2020

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Clinical manifestations of COVID-19 caused by the new coronavirus SARS-CoV-2 are associated with age 1,2. Adults develop respiratory symptoms, which can progress to acute respiratory distress syndrome (ARDS) in the most severe form, while children are largely spared from respiratory illness but can develop a life-threatening multisystem inflammatory syndrome (MIS-C) 3-5. Here, we show distinct antibody responses in children and adults after SARS-CoV-2 infection. Adult COVID-19 cohorts had anti-spike (S) IgG, IgM and IgA antibodies, as well as anti-nucleocapsid (N) IgG antibody, while children with and without MIS-C had reduced breadth of anti-SARS-CoV-2-specific antibodies, predominantly generating IgG antibodies specific for the S protein but not the N protein. Moreover, children with and without MIS-C had reduced neutralizing activity as compared to both adult COVID-19 cohorts, indicating a reduced protective serological response. These results suggest a distinct infection course and immune response in children independent of whether they develop MIS-C, with implications for developing age-targeted strategies for testing and protecting the population. The clinical manifestations of SARS-CoV-2 infection in children are distinct from adults. Children with COVID-19 rarely exhibit severe respiratory symptoms and often remain asymptomatic 2 , whereas adults experience respiratory symptoms of varying severity; older adults and those with comorbidities such as hypertension and diabetes have substantially higher risks of developing COVID-19-associated ARDS with high mortality 2,6. In children, a rare but severe clinical manifestation of SARS-CoV-2 infection designated MIS-C, exhibits similarities to Kawasaki disease in certain inflammatory features and cardiovascular involvement while generally lacking severe respiratory symptoms 3-5. The nature of the immune response to SARS-CoV-2 in children with different clinical manifestations ranging from asymptomatic to MIS-C relative to the more common respiratory manifestations of COVID-19 in adults is unclear. The generation of virus-specific antibodies that neutralize or block infectivity is the most consistent correlate of protective immunity for multiple infections and vaccines 7,8. Antibodies specific for the major SARS-CoV-2 antigens, including the S protein which binds the cellular receptor for viral entry and the N protein necessary for viral replication, have been detected in actively infected patients and in patients with mild disease who recovered 9-12. Anti-S antibodies, in particular, can exhibit potent neutralizing activity and are currently being pursued as a therapeutic option for infusion into patients during severe disease and for targeted generation in vaccines 13-15. Defining the nature of the antibody response to SARS-CoV-2 infection as a function of age and clinical syndrome can provide essential insights for improved screening and targeted protection for the global population that continues to suffer from this relentless pandemic. In this study, we inves...

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“…More than 660,000 deaths attributable to COVID-19 have been reported worldwide, and in the UK alone above 50,000 death registrations have mentioned COVID-19 [1] and over 130,000 people have been hospitalised with the disease [2] as of 29 th July 2020. As the pandemic has evolved, a growing body of evidence has emerged on the clinical risk factors associated with COVID-19 hospitalisation and death, including age, sex, obesity, and certain chronic conditions including diabetes, hypertension, lung disease and cardiovascular disease [3,4,5]. However, evidence also suggests that socio-economic factors may be drivers of variations in COVID-19 morbidity and mortality [6].…”

Section: Introductionmentioning

confidence: 99%

Ethnic minority groups in England and Wales - factors affecting the size and timing of elevated COVID-19 mortality: a retrospective cohort study linking Census and death records

Ayoubkhani

Nafilyan

White

et al. 2020

Preprint

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Objectives: To estimate population-level associations between ethnicity and coronavirus disease 2019 (COVID-19) mortality, and to investigate how ethnicity-specific mortality risk evolved over the course of the pandemic. Design: Retrospective cohort study using linked administrative data. Setting: England and Wales, deaths occurring 2 March to 15 May 2020. Participants: Respondents to the 2011 Census of England and Wales aged ≤100 years and enumerated in private households, linked to death registrations and adjusted to account for emigration before the outcome period, who were alive on 1 March 2020 (n=47,872,412). Main outcome measure: Death related to COVID-19, registered by 29 May 2020. Statistical methods: We estimated hazard ratios (HRs) for ethnic minority groups compared with the White population using Cox regression models, controlling for geographical, demographic, socio-economic, occupational, and self-reported health factors. HRs were estimated on the full outcome period and separately for pre- and post-lockdown periods in the UK. Results: In the age-adjusted models, people from all ethnic minority groups were at elevated risk of COVID-19 mortality; the HRs for Black males and females were 3.13 [95% confidence interval: 2.93 to 3.34] and 2.40 [2.20 to 2.61] respectively. However, in the fully adjusted model for females, the HRs were close to unity for all ethnic groups except Black (1.29 [1.18 to 1.42]). For males, COVID-19 mortality risk remained elevated for the Black (1.76 [1.63 to 1.90]), Bangladeshi/Pakistani (1.35 [1.21 to 1.49]) and Indian (1.30 [1.19 to 1.43]) groups. The HRs decreased after lockdown for all ethnic groups, particularly Black and Bangladeshi/Pakistani females. Conclusions: Differences in COVID-19 mortality between ethnic groups were largely attenuated by geographical and socio-economic factors, although some residual differences remained. Lockdown was associated with reductions in excess mortality risk in ethnic minority populations, which has major implications for a second wave of infection or local spikes. Further research is needed to understand the causal mechanisms underpinning observed differences in COVID-19 mortality between ethnic groups.

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Prevalence of co‐morbidities and their association with mortality in patients with COVID‐19: A systematic review and meta‐analysis

Cited by 382 publications

References 47 publications

Prognostic value of liver biochemical parameters for COVID-19 mortality

Prognostic value of liver biochemical parameters for COVID-19 mortality

Distinct antibody responses to SARS-CoV-2 in children and adults across the COVID-19 clinical spectrum

Ethnic minority groups in England and Wales - factors affecting the size and timing of elevated COVID-19 mortality: a retrospective cohort study linking Census and death records

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