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Research Paper|Volume 12, Issue 13|pp 12493—12503

Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis

Xiaoyu Fang1,2, Shen Li3, Hao Yu4, Penghao Wang3, Yao Zhang2, Zheng Chen2, Yang Li5, Liqing Cheng6, Wenbin Li7, Hong Jia1, Xiangyu Ma2
  • 1College of Public Health, Southwest Medical University, Luzhou, Sichuan Province, China
  • 2Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
  • 3The Second Clinical College, Chongqing Medical University, Chongqing, China
  • 4Department of Endocrinology, Northern Theater Command General Hospital, Shenyang, China
  • 5NCO School of Army Medical University, Shijiazhuang, China
  • 6Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing, China
  • 7Outpatient Clinic of Dali Retreat Center for Former Cadres of Yunnan Military Region, Dali, China
* Equal contribution
# These authors jointly direct this project
Received: May 1, 2020Accepted: June 12, 2020Published: July 13, 2020
https://doi.org/10.18632/aging.103579

Copyright © 2020 Fang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

A systematic review and meta-analysis was conducted in an attempt to systematically collect and evaluate the associations of epidemiological, comorbidity factors with the severity and prognosis of coronavirus disease 2019 (COVID-19). The systematic review and meta-analysis was conducted according to the guidelines proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Sixty nine publications met our study criteria, and 61 studies with more than 10,000 COVID-19 cases were eligible for the quantitative synthesis. We found that the males had significantly higher disease severity (RR: 1.20, 95% CI: 1.13-1.27, P <0.001) and more prognostic endpoints. Older age was found to be significantly associated with the disease severity and six prognostic endpoints. Chronic kidney disease contributed mostly for death (RR: 7.10, 95% CI: 3.14-16.02), chronic obstructive pulmonary disease (COPD) for disease severity (RR: 4.20, 95% CI: 2.82-6.25), admission to intensive care unit (ICU) (RR: 5.61, 95% CI: 2.68-11.76), the composite endpoint (RR: 8.52, 95% CI: 4.36-16.65,), invasive ventilation (RR: 6.53, 95% CI: 2.70-15.84), and disease progression (RR: 7.48, 95% CI: 1.60-35.05), cerebrovascular disease for acute respiratory distress syndrome (ARDS) (RR: 3.15, 95% CI: 1.23-8.04), coronary heart disease for cardiac abnormality (RR: 5.37, 95% CI: 1.74-16.54). Our study highlighted that the male gender, older age and comorbidities owned strong epidemiological evidence of associations with the severity and prognosis of COVID-19.