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Cited by 284COVID-19 Clinical Research StudiesCOVID-19 epidemiological studiesLong-Term Effects of COVID-19

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A systematic review and meta-analysis of geographic differences in comorbidities and associated severity and mortality among individuals with COVID-19

Open access
Thakur, Bhaskar, Dubey, Pallavi, Benitez, Joseph, Torres, Joshua P., Reddy, Sireesha, Shokar, Navkiran, Aung, Koko, Mukherjee, Debabrata, Dwivedi, Alok Kumar·2021·Scientific Reports
DOI 10.1038/s41598-021-88130-wPMC PMC8058064
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Abstract

Several comorbidities have been shown to be associated with coronavirus disease 2019 (COVID-19) related severity and mortality. However, considerable variation in the prevalence estimates of comorbidities and their effects on COVID-19 morbidity and mortality have been observed in prior studies. This systematic review and meta-analysis aimed to determine geographical, age, and gender related differences in the prevalence of comorbidities and associated severity and mortality rates among COVID-19 patients. We conducted a search using PubMed, Scopus, and EMBASE to include all COVID-19 studies published between January 1st, 2020 to July 24th, 2020 reporting comorbidities with severity or mortality. We included studies reporting the confirmed diagnosis of COVID-19 on human patients that also provided information on comorbidities or disease outcomes. We used DerSimonian and Laird random effects method for calculating estimates. Of 120 studies with 125,446 patients, the most prevalent comorbidity was hypertension (32%), obesity (25%), diabetes (18%), and cardiovascular disease (16%) while chronic kidney or other renal diseases (51%, 44%), cerebrovascular accident (43%, 44%), and cardiovascular disease (44%, 40%) patients had more COVID-19 severity and mortality respectively. Considerable variation in the prevalence of comorbidities and associated disease severity and mortality in different geographic regions was observed. The highest mortality was observed in studies with Latin American and European patients with any medical condition, mostly older adults (≥ 65 years), and predominantly male patients. Although the US studies observed the highest prevalence of comorbidities in COVID-19 patients, the severity of COVID-19 among each comorbid condition was highest in Asian studies whereas the mortality was highest in the European and Latin American countries. Risk stratification and effective control strategies for the COVID-19 should be done according to comorbidities, age, and gender differences specific to geographical location.

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Crossref · 10.1038/s41598-021-88130-w

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Figures

Figure 1 PRISMA flowchart for the selection of studies at different stages.
Figure 1 PRISMA flowchart for the selection of studies at different stages.CC BY · PubMed Central
Figure 2 Prevalence of comorbidities among COVID-19 patients.
Figure 2 Prevalence of comorbidities among COVID-19 patients.CC BY · PubMed Central
Figure 3 Proportion of COVID-19 severity among patients with underlying medical comorbidities.
Figure 3 Proportion of COVID-19 severity among patients with underlying medical comorbidities.CC BY · PubMed Central
Figure 4 Proportion of mortality among COVID-19 patients with underlying medical comorbidities.
Figure 4 Proportion of mortality among COVID-19 patients with underlying medical comorbidities.CC BY · PubMed Central

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Metadata

Authors
Thakur, B., Dubey, P., Benitez, J., Torres, J. P., Reddy, S., Shokar, N., Aung, K., Mukherjee, D., & Dwivedi, A. K.
Affiliations
  • Texas Tech University Health Sciences Center (US)
  • Texas Tech University (US)
Corresponding author
Dwivedi, Alok Kumar
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2021-04-20
Volume
11
Issue
1
Pages
8562-8562
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-021-88130-w
PMC
PMC8058064
OpenAlex
W3152572687
Cited by
284
References
59
Citations by year
2026: 11 · 2025: 17 · 2024: 53 · 2023: 66 · 2022: 95 · 2021: 41
FWCI
7.45
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Keywords
COVID-19 pandemic, comorbidities, disease severity, mortality, regional variation, hypertension, obesity, diabetes mellitus, cardiovascular disease, chronic kidney disease, cerebrovascular disease, age differences, sex differences, risk stratification
MeSH terms
COVID-19, Age Factors, Aged, Aged, 80 and over, Asia, Europe, Female, Humans, Latin America, Male, Severity of Illness Index, Sex Factors, Comorbidity, Prevalence

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