This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
The influence of comorbidity on the severity of COVID-19 disease: A scoping review and meta-analysis
Nazar Zaki
United Arab Emirates University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6259-9843
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: A novel form of coronavirus disease (SARS-CoV-2) has spread rapidly across the world. What risk factors influence the severity of the disease is of considerable importance. Objectives: This research offers a systematic review and meta-analysis of the correlation between common clinical conditions and comorbidities and the severity of COVID-19. Methodology: Two independent researchers searched Europe PMC, Google Scholar, and PubMed databases for articles related to influence comorbidities have on the progress of the disease. A search engine was also created to screen a further 59,000 articles in COVID-19 Open Research Dataset (CORD-19). Random-effects modeling was used to pool 95% confidence intervals (CIs) and odds ratios (ORs). The significance of all comorbidities and clinical conditions to the severity of the disease was evaluated by employing machine-learning techniques. Publication bias was assessed by using funnel-plots and Egger’s-test. Heterogeneity was tested using I2. Results: The meta-analysis incorporated 12 studies spanning 4,101 confirmed COVID-19 patients who were admitted to Chinese hospitals. The prevalence of the most commonly associated co-morbidities and their corresponding odds ratio for disease severity were as follows: coronary heart disease (OR 2.97 CI: 1.99-4.45, p < 0.0001), cancer (OR 2.65 CI: 1.12-6.29, p < 0.03), cardiovascular disease (OR 2.89 CI: 1.90-4.40, p < 0.0001), COPD (OR 3.24 CI: 1.66-6.32, p = 0.0), and kidney disease (OR 2.2.4 CI: 1.01-4.99, p = 0.05) with low or moderate level of heterogeneity. The most frequently exhibited clinical symptoms recorded during the course of admission were fever (OR 1.37 CI: 1.01-1.86, p = 0.04), myalgia/fatigue (OR 1.31 CI: 1.11-1.55, p = 0.0018), and dyspnea (OR 3.61, CI: 2.57-5.06, p = <0.0001). No significant associations between disease severity and liver disease, smoking habits, and other clinical conditions, such as a cough, respiratory/ARDS, diarrhea or chest tightness/pain were found. The meta-analysis also revealed that the incubation period was positively associated with disease severity. Conclusion: Existing comorbidities, including COPD, cardiovascular disease, and coronary heart disease, increase the severity of COVID-19. Some studies found a statistically significant association between comorbidities such as diabetes and hypertension and disease severity. However, these studies may be biased due to substantial heterogeneity.
Keywords
COVID-19, meta-analysis, cardiovascular disease, hypertension, diabetes, SARS-CoV-2
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
This is a list of supplementary files associated with this preprint. Click to download.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 3
Posted 19 Aug, 2020
No community comments so far
No comments provided
No comments provided
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Learn more about our company.
This is a preprint. It has not completed peer review.
Research article
The influence of comorbidity on the severity of COVID-19 disease: A scoping review and meta-analysis
Nazar Zaki
United Arab Emirates University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6259-9843
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 3
Posted 19 Aug, 2020
No community comments so far
No comments provided
No comments provided
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: A novel form of coronavirus disease (SARS-CoV-2) has spread rapidly across the world. What risk factors influence the severity of the disease is of considerable importance. Objectives: This research offers a systematic review and meta-analysis of the correlation between common clinical conditions and comorbidities and the severity of COVID-19. Methodology: Two independent researchers searched Europe PMC, Google Scholar, and PubMed databases for articles related to influence comorbidities have on the progress of the disease. A search engine was also created to screen a further 59,000 articles in COVID-19 Open Research Dataset (CORD-19). Random-effects modeling was used to pool 95% confidence intervals (CIs) and odds ratios (ORs). The significance of all comorbidities and clinical conditions to the severity of the disease was evaluated by employing machine-learning techniques. Publication bias was assessed by using funnel-plots and Egger’s-test. Heterogeneity was tested using I2. Results: The meta-analysis incorporated 12 studies spanning 4,101 confirmed COVID-19 patients who were admitted to Chinese hospitals. The prevalence of the most commonly associated co-morbidities and their corresponding odds ratio for disease severity were as follows: coronary heart disease (OR 2.97 CI: 1.99-4.45, p < 0.0001), cancer (OR 2.65 CI: 1.12-6.29, p < 0.03), cardiovascular disease (OR 2.89 CI: 1.90-4.40, p < 0.0001), COPD (OR 3.24 CI: 1.66-6.32, p = 0.0), and kidney disease (OR 2.2.4 CI: 1.01-4.99, p = 0.05) with low or moderate level of heterogeneity. The most frequently exhibited clinical symptoms recorded during the course of admission were fever (OR 1.37 CI: 1.01-1.86, p = 0.04), myalgia/fatigue (OR 1.31 CI: 1.11-1.55, p = 0.0018), and dyspnea (OR 3.61, CI: 2.57-5.06, p = <0.0001). No significant associations between disease severity and liver disease, smoking habits, and other clinical conditions, such as a cough, respiratory/ARDS, diarrhea or chest tightness/pain were found. The meta-analysis also revealed that the incubation period was positively associated with disease severity. Conclusion: Existing comorbidities, including COPD, cardiovascular disease, and coronary heart disease, increase the severity of COVID-19. Some studies found a statistically significant association between comorbidities such as diabetes and hypertension and disease severity. However, these studies may be biased due to substantial heterogeneity.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6