The negative impact of comorbidities on the disease course of COVID-19

Abstract

Dear Editor, Coronavirus Disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with a mortality rate of 3-7% [1]. The high mortality results from fulminant pneumonia leading to acute respiratory distress syndrome and multiple organ failure [2, 3]. Initial reports suggest that comorbidities cause a more severe course of infection and a poorer prognosis [4, 5]. Considering the fast spread and high mortality of COVID-19, it is necessary to understand the possible risk factors affecting its progression. We aimed to perform a systematic search to evaluate the potential role of all reported comorbidities on the disease course. Details of our report are provided in Supplementary file 1. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus between 01/01/2020 and 05/11/2020. The main outcomes were mortality, intensive care unit (ICU) admission and severity. Definitions of the investigated outcomes are available in Supplementary file 2, Table 2. Odds ratios (OR) with 95% confidence intervals (CI) were calculated to objectify the association between comorbidities and the outcomes by the random-effects model. The study was registered on PROSPERO (CRD42020176781). Of 33,987 records screened, 61 cohort studies with 31,089 (median 162; IQR: 103-338) patients were included in the meta-analysis. The overall mortality rate was 10.0%, 19.9% of patients needed intensive, while the reported severity was 24.0%. Underlying chronic

Visceral Adiposity Elevates the Risk of Critical Condition in COVID‐19: A Systematic Review and Meta‐Analysis

“…With the escalation of the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), recognizing risk factors is of utmost importance. Among other risk factors such as age and comorbidities (1,2), a higher BMI has been acknowledged as a risk factor for developing critical condition in coronavirus disease 2019 (COVID‐19) in our former analysis and in other articles since then (3‐6). Because the obesity epidemic is rapidly spreading worldwide, it is vital to accurately identify patients with a higher risk for developing critical condition in COVID‐19.…”

Pre-existing Liver Diseases and On-Admission Liver-Related Laboratory Tests in COVID-19: A Prognostic Accuracy Meta-Analysis With Systematic Review

“…It is important to explore the prognostic factors, which have a significant impact on the disease course, given the rapid spread of COVID-19 and its high mortality rate. The detrimental effects of hypertension, cardiovascular diseases, kidney disease, and diabetes mellitus on the disease course are already proven (4)(5)(6). Due to the limited number of reports on COVID-19 with underlying chronic liver disease (CLD) to date, the impact of pre-existing liver pathologies on COVID-19 progression and outcomes is unknown.…”

COVID-19: Second Wave or Multiple Peaks, Natural Herd Immunity or Vaccine – We Should be Prepared

“…Control of ComorbiditiesSpecific comorbidities have been reported among severe cases of COVID-19 in different cohort studies from countries around the world. To date, there are no studies reporting a direct causal relationship between these underlying diseases and the development of COVID-19[20][21][22][23]. Some conditions are rather significantly associated with critical care unit admission, poor prognosis, and mortality in SARS-CoV-2-infected cases[20][21][22][23].…”

“…To date, there are no studies reporting a direct causal relationship between these underlying diseases and the development of COVID-19[20][21][22][23]. Some conditions are rather significantly associated with critical care unit admission, poor prognosis, and mortality in SARS-CoV-2-infected cases[20][21][22][23]. The most common comorbidities associated with worsening patient outcome are hypertension, diabetes, cardiovascular disease, chronic respiratory disease, immune-compromised status, cancer, and obesity[20][21][22][23].…”

“…Some conditions are rather significantly associated with critical care unit admission, poor prognosis, and mortality in SARS-CoV-2-infected cases[20][21][22][23]. The most common comorbidities associated with worsening patient outcome are hypertension, diabetes, cardiovascular disease, chronic respiratory disease, immune-compromised status, cancer, and obesity[20][21][22][23]. The presence of more than one comorbidity also correlates with worse clinical outcomes among COVID-19 cases[20][21][22][23].Considering the rapid spread and high mortality rates associated with COVID-19, it is important and logical for one to control these comorbid conditions, given their strong association with severe disease and poor prognosis.Patients with Type 2 Diabetes, for example, are prone to have other components of the metabolic syndrome, including hypertension and dyslipidemia, in addition to probable obesity.…”