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Comorbid Chronic Diseases are Strongly Correlated with Disease Severity among COVID-19 Patients: A Systematic Review
Hong Liu1, Shiyan Chen2, Min Liu1
11Department of Nutrition, the Third Xiangya Hospital of Central South University, Changsha, China.
Insights
Chronic diseases like diabetes and hypertension significantly increase COVID-19 severity. While these conditions raise the risk of severe illness, they surprisingly showed no correlation with increased mortality in COVID-19 patients.
Area of Science:
- Infectious Diseases
- Epidemiology
- Cardiology
- Endocrinology
Background:
- Coronavirus disease 2019 (COVID-19) has caused significant global morbidity and mortality.
- Understanding the impact of pre-existing chronic conditions on COVID-19 outcomes is crucial for patient management.
Purpose of the Study:
- To investigate the association between comorbid chronic diseases and clinical outcomes in COVID-19 patients.
- To determine the prevalence of common chronic conditions among hospitalized COVID-19 cases.
Main Methods:
- A systematic literature search was conducted across major biomedical databases (PubMed, MEDLINE, EMBASE, CDC, NIH) up to April 25, 2020.
- Meta-analysis of 24 peer-reviewed articles comprising 10,948 COVID-19 cases was performed.
- Odds ratios (OR) and 95% confidence intervals (CI) were calculated to assess the risk of severe disease and mortality.
Main Results:
- Diabetes (10.0%), hypertension (20.0%), and coronary artery/cardiovascular disease (CAD/CVD) (8.0%) were more prevalent in COVID-19 patients than chronic pulmonary disease (3.0%).
- Preexisting chronic conditions were strongly correlated with increased disease severity (OR 3.50) and intensive care unit (ICU) admission (OR 3.36).
- Diabetes, hypertension, CAD/CVD, and chronic pulmonary disease were all associated with a higher risk of developing severe COVID-19, with ORs ranging from 2.61 to 4.18.
- No significant correlation was found between chronic conditions and increased mortality risk (OR 2.09).
Conclusions:
- Cardio-metabolic diseases are common comorbidities in COVID-19 patients and are linked to increased disease severity.
- While chronic conditions increase the risk of severe COVID-19, active treatment may mitigate the associated mortality risk.
- Further research is warranted to elucidate the mechanisms linking chronic diseases to COVID-19 severity and outcomes.
Abstract:
Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. In order to explore the effects of comorbid chronic diseases on clinical outcomes of COVID-19, a search was conducted in PubMed, Ovid MEDLINE, EMBASE, CDC, and NIH databases to April 25, 2020. A total of 24 peer-reviewed articles, including 10948 COVID-19 cases were selected. We found diabetes was present in 10.0%, coronary artery disease/cardiovascular disease (CAD/CVD) was in 8.0%, and hypertension was in 20.0%, which were much higher than that of chronic pulmonary disease (3.0%). Specifically, preexisting chronic conditions are strongly correlated with disease severity [Odds ratio (OR) 3.50, 95% CI 1.78 to 6.90], and being admitted to intensive care unit (ICU) (OR 3.36, 95% CI 1.67 to 6.76); in addition, compared to COVID-19 patients with no preexisting chronic diseases, COVID-19 patients who present with either diabetes, hypertension, CAD/CVD, or chronic pulmonary disease have a higher risk of developing severe disease, with an OR of 2.61 (95% CI 1.93 to 3.52), 2.84 (95% CI 2.22 to 3.63), 4.18 (95% CI 2.87 to 6.09) and 3.83 (95% CI 2.15 to 6.80), respectively. Surprisingly, we found no correlation between chronic conditions and increased risk of mortality (OR 2.09, 95% CI 0.26 to16.67). Taken together, cardio-metabolic diseases, such as diabetes, hypertension and CAD/CVD were more common than chronic pulmonary disease in COVID-19 patients, however, each comorbid disease was correlated with increased disease severity. After active treatment, increased risk of mortality in patients with preexisting chronic diseases may reduce.
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