ObjectiveWe aimed to describe the associations of age and sex with the risk of COVID-19 in different severity stages ranging from infection to death.DesignSystematic review and meta-analysis.Data sourcesPubMed and Embase through 4 May 2020.Study selectionWe considered cohort and case–control studies that evaluated differences in age and sex on the risk of COVID-19 infection, disease severity, intensive care unit (ICU) admission and death.Data extraction and synthesisWe screened and included studies using standardised electronic data extraction forms and we pooled data from published studies and data acquired by contacting authors using random effects meta-analysis. We assessed the risk of bias using the Newcastle-Ottawa Scale.ResultsWe screened 11.550 titles and included 59 studies comprising 36.470 patients in the analyses. The methodological quality of the included papers was high (8.2 out of 9). Men had a higher risk for infection with COVID-19 than women (relative risk (RR) 1.08, 95% CI 1.03 to 1.12). When infected, they also had a higher risk for severe COVID-19 disease (RR 1.18, 95% CI 1.10 to 1.27), a higher need for intensive care (RR 1.38, 95% CI 1.09 to 1.74) and a higher risk of death (RR 1.50, 95% CI 1.18 to 1.91). The analyses also showed that patients aged 70 years and above have a higher infection risk (RR 1.65, 95% CI 1.50 to 1.81), a higher risk for severe COVID-19 disease (RR 2.05, 95% CI 1.27 to 3.32), a higher need for intensive care (RR 2.70, 95% CI 1.59 to 4.60) and a higher risk of death once infected (RR 3.61, 95% CI 2.70 to 4.84) compared with patients younger than 70 years.ConclusionsMeta-analyses on 59 studies comprising 36.470 patients showed that men and patients aged 70 and above have a higher risk for COVID-19 infection, severe disease, ICU admission and death.PROSPERO registration numberCRD42020180085.

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IntroductionEarly literature on the COVID-19 pandemic indicated striking ethnic inequalities in SARS-CoV-2-related outcomes. This systematic review and meta-analysis aimed to describe the presence and magnitude of associations between ethnic groups and COVID-19-related outcomes.MethodsPubMed and Embase were searched from December 2019 through September 2020. Studies reporting extractable data (ie, crude numbers, and unadjusted or adjusted risk/ORs) by ethnic group on any of the five studied outcomes: confirmed COVID-19 infection in the general population, hospitalisation among infected patients, and disease severity, intensive care unit (ICU) admission and mortality among hospitalised patients with SARS-CoV-2 infection, were included using standardised electronic data extraction forms. We pooled data from published studies using random-effects meta-analysis.Results58 studies were included from seven countries in four continents, mostly retrospective cohort studies, covering a total of almost 10 million individuals from the first wave until the summer of 2020. The risk of diagnosed SARS-CoV-2 infection was higher in most ethnic minority groups than their White counterparts in North American and Europe with the differences remaining in the US ethnic minorities after adjustment for confounders and explanatory factors. Among people with confirmed infection, African-Americans and Hispanic-Americans were also more likely than White-Americans to be hospitalised with SARS-CoV-2 infection. No increased risk of COVID-19 outcomes (ie, severe disease, ICU admission and death) was found among ethnic minority patients once hospitalised, except for a higher risk of death among ethnic minorities in Brazil.ConclusionThe risk of SARS-CoV-2 diagnosis was higher in most ethnic minorities, but once hospitalised, no clear inequalities exist in COVID-19 outcomes except for the high risk of death in ethnic minorities in Brazil. The findings highlight the necessity to tackle disparities in social determinants of health, preventative opportunities and delay in healthcare use. Ethnic minorities should specifically be considered in policies mitigating negative impacts of the pandemic.PROSPERO registration numberCRD42020180085.

Background Onset of dementia before the age of 65 years is usually referred to as young onset dementia (YOD). Out of the total prevalence of dementia, it is estimated that 6‐9% are accounted for by YOD, but data to build robust estimates on is very limited in this specific dementia subgroup. Valid epidemiological data on the prevalence of people with YOD is needed to adequately provide dedicated services and care. This systematic review aimed to collate data from published literature and estimate the prevalence of YOD. Method A comprehensive literature search in PubMed, Embase, CINAHL and PsychINFO was conducted to identify population‐based studies on the prevalence of dementia in a population aged under 65. Articles published between 1990 and 30 November 2018 were screened independently by two authors in two phases: 1) screening titles and abstracts, 2) screening full texts, according to the PRISMA‐guidelines. Data were extracted and all articles were assessed on quality and risk of bias. Study authors were contacted when data was missing or to obtain full texts. Random‐effect meta‐analyses were pooled estimates and assessed sources of between‐study differences. The study is registered with PROSPERO, number CRD42019119288. Result The systematic search yielded 10,370 articles. After screening and cross‐referencing 88 articles were included in the review. Eligible articles were pooled together in meta‐analyses. Subgroups were made amongst others for type of dementia, age ranges and sex. The overall pooled estimate for young onset dementia over all age ranges and all types of dementia was 0.20% (95%CI = 0.15‐0.26). The prevalence for females was 0.25% (95%CI = 0.16‐0.35), whereas the prevalence for males was 0.16% (95%CI = 0.10‐0.23). Prevalence ranged from 0.01% (95% CI= 0.00‐0.01) in the age group 30‐34, to 0.98% (95% CI = 0.72‐1.28) in the age group 60‐64. Heterogeneity across studies was high, articles differed in many methodological aspects. Meta‐regression and subgroup analyses into sources of between‐study differences in prevalence estimates are currently analyzed and will be presented. Conclusion Articles eligible for meta‐analysis showed an overall prevalence of 0.21%, with females having a slightly higher prevalence compared to males, and an increased prevalence with increasing age.

Introduction: Reliable data on the incidence rates for young-onset dementia (YOD) are lacking, but are necessary for research on disease etiology and to raise awareness among health care professionals. Methods:We performed a systematic review and meta-analysis on population-based studies on the incidence of YOD, published between January 1, 1990 and February 1, 2022, according to Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Data were analyzed using random-effects meta-analyses. Results were age-standardized, and heterogeneity was assessed by subgroup analyses and meta-regression.Results: Sixty-one articles were included. Global age-standardized incidence rates increased from 0.17/100,000 in age 30 to 34 years, to 5.14/100,000 in age 60 to 64 years, giving a global total age-standardized incidence rate of 11 per 100,000 in age 30 to 64. This corresponds to 370,000 new YOD cases annually worldwide. Heterogeneity was high and meta-regression showed geographic location significantly influenced this heterogeneity.Discussion: This meta-analysis shows the current best estimate of YOD incidence. New prospective cohort studies are needed.