Background: 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.
Aim: This research is intended to offer a systematic review/meta-analysis for assessing how common clinical conditions and comorbidities correlate with COVID-19.
Methodology: Two independent researchers undertook searches using Europe PMC, Google Scholar, and PubMed. In addition, a search engine was created for screening another 59,000 articles in COVID-19 Open Research Dataset (CORD-19). Screening was undertaken for any article related to comorbidity and their influence on the progress of the disease. Random-effects modeling was used to pool 95% confidence intervals (CIs) and odds ratios (ORs). The significance of all comorbidities and clinical conditions in relation to the severity of the disease were evaluated by employing feature extraction methods and machine-learning. Publication bias was assessed by employing funnel plots, and heterogeneity was tested in relation to I2.
Results: The meta-analysis incorporated 12 studies covering 4101 confirmed COVID-19 patients from Chinese hospitals. The findings demonstrate that the most common comorbidities with the disease were hypertension (22.07%, OR 2.43 [95% CI: 1.71-3.45], p <0.0001), diabetes (11.34%, OR 2.27, [95% CI: 1.46-3.53], p = 0.0003), cardiovascular disease (10.76%, OR 2.89 [95% CI: 1.90-4.40], p <0.0001), and COPD (2.53%, OR 3.24 [95% CI: 1.99-4.45], p< 0.0006). 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), and respiratory failure/ARDS (20.6%, OR 11.46, 95% CI: 3.24-40.56, p = 0.0002). Meta-analysis also revealed that neither the duration of the incubation period nor current smoking status associated with disease severity.
Conclusion: Existing comorbidities, including COPD, cardiovascular disease, coronary heart disease, diabetes, and hypertension represent a risk of increasing the severity of the disease in COVID-19 patients.