Coronavirus (COVID-19): A Systematic Review and Meta-analysis to Evaluate the Significance of Demographics and Comorbidities

Abstract

Background The unprecedented outbreak of a contagious respiratory disease caused by a novel coronavirus has led to a pandemic since December 2019, claiming millions of lives. The study systematically reviews and summarizes COVID-19’s impact based on symptoms, demographics, comorbidities, and demonstrates the association of demographics in cases and mortality in the United States.Methods PubMed and Google Scholar were searched from December 2019- August 2020, and articles restricted to the English language were collected following PRISMA guidelines. US CDC data was used for establishing statistical significance of age, sex, and race.Results• Among 3745 patients in China, mean age is 50.63 (95% CI: 36.84, 64.42) years, and 55.7 % (95% CI: 52.2, 59.2) were males. Symptoms included fever 86.5% (82.7, 90.0), fatigue 41.9% (32.7, 51.4), dyspnea 29.0% (21.2, 37.5), cough 66.0% (61.3, 70.6), mucus 66% (61.3, 70.6), lymphopenia 18.9% (5.2, 38.0). Prevalent comorbidities were hypertension 16.4% (12.5, 20.8), diabetes 8.9% (7.0, 11.1), CVD 10.9% (6.1, 16.7), ARDS 14.6% (4.9, 27.8), malignancy 1.5 ( 0.05, 2.8), 1.3% (0.08, 1.9), COPD 1.3 (0.08, 1.9). 63.5 % (33.5, 88.7) received oxygen therapy, 20.8% (8.9, 35.7) were in ventilation, 23.5% (5.9, 47.8) were at the ICU. 86.5% (76.8, 94) had antiviral, 73.9% (55.3, 89.0) had antibiotics, 30% (20.6, 40.2) corticosteroids treatment.• In the US, the odds ratio of infection in males to females is 0.873 (CI: 0.052,14.791), while the odds of dying from infection is 1.378 (CI: 0.081, 23.528) for males. The prevalence of infection is higher in females; case and death rates are higher in whites and Hispanics than other races; the death rate is higher in males irrespective of race and age; death rate per 100,000 population increases monotonically with age.Conclusion Results showed that metabolic diseases comprising CVD, diabetes, hypertension, and respiratory diseases, including COPD, ARDS, are the most common comorbidities to severe condition and poor prognosis in covid-19 patients. Following the recent FDA's guidance for designing Covid-19 vaccine trials, stratification factors of age, race, sex, and comorbidities need consideration in allocation. This study aimed to provide clinical researchers, health policy planners a detailed insight into the coronavirus disease.

Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020

“…Similar findings were observed in other studies, including meta-analyses for coronary heart disease and COVID-19 [26,27]. A systematic review and meta-analysis carried out to evaluate the significance of demographics and comorbidities in COVID-19 demonstrated that metabolic diseases, comprising CVD, diabetes, hypertension and respiratory diseases (COPD and others), were the most common comorbidities associated with a severely poor prognosis and severe outcomes [28]. Between March and September 2020, a cross-sectional study carried out in 25 hospitals in the South and Southeast regions of Brazil concluded that the high risk of hospital mortality was associated with having hypertension, being male, ages over 69 years, having kidney disease and for patients who were admitted in the ICU, mortality was 47.6% [29].…”

Anticoagulants and Antiplatelets in COVID-19: Impact on Survival and Thromboembolism Development

“…Regarding population characteristics, it is unsurprising that age, male sex, active cancer, and current smoking habit were associated with poorer survival, as this has been demonstrated by numerous other studies [9,30–35]. The observation that survival was increased in those undergoing surgery during admission or in the 12 weeks prior to presentation is of note, but is potentially due to a better baseline of health.…”

Body-mass index COVID-19 severity: A systematic review of systematic reviews

“…[ 31 ] Reasons for excluding nine studies are as shown in Table 1 . [ 37 38 39 40 41 42 43 44 45 ] Twenty ( n = 20) reviews[ 14 15 16 17 18 19 20 22 23 24 26 28 29 30 31 32 33 34 36 46 ] reported the association between Obesity and disease severity of covid-19. Out of these, five[ 14 16 23 26 30 ] reported severe disease with poor composite outcomes (including mortality).…”