Association of Patients’ Epidemiological Characteristics and Comorbidities with Severity and Related Mortality Risk of SARS-CoV-2 Infection: Results of an Umbrella Systematic Review and Meta-Analysis
Eduardo Reyna-Villasmil,
Maria Giulia Caponcello,
Natalia Maldonado,
Paula Olivares,
Natascia Caroccia,
Cecilia Bonazzetti,
Beatrice Tazza,
Elena Carrara,
Maddalena Giannella,
Evelina Tacconelli,
Jesús Rodríguez-Baño,
Zaira R. Palacios-Baena
Affiliations
Eduardo Reyna-Villasmil
Unit of Infectious Diseases and Clinical Microbiology, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBIS)/CSIC, 41008 Seville, Spain
Maria Giulia Caponcello
Unit of Infectious Diseases and Clinical Microbiology, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBIS)/CSIC, 41008 Seville, Spain
Natalia Maldonado
Unit of Infectious Diseases and Clinical Microbiology, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBIS)/CSIC, 41008 Seville, Spain
Paula Olivares
Unit of Infectious Diseases and Clinical Microbiology, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBIS)/CSIC, 41008 Seville, Spain
Natascia Caroccia
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
Cecilia Bonazzetti
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
Beatrice Tazza
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
Elena Carrara
Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy
Maddalena Giannella
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
Evelina Tacconelli
Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy
Jesús Rodríguez-Baño
Unit of Infectious Diseases and Clinical Microbiology, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBIS)/CSIC, 41008 Seville, Spain
Zaira R. Palacios-Baena
Unit of Infectious Diseases and Clinical Microbiology, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBIS)/CSIC, 41008 Seville, Spain
The objective of this study was to assess the association between patients’ epidemiological characteristics and comorbidities with SARS-CoV-2 infection severity and related mortality risk. An umbrella systematic review, including a meta-analysis examining the association between patients’ underlying conditions and severity (defined as need for hospitalization) and mortality of COVID-19, was performed. Studies were included if they reported pooled risk estimates of at least three underlying determinants for hospitalization, critical disease (ICU admission, mechanical ventilation), and hospital mortality in patients diagnosed with SARS-CoV-2 infection. Evidence was summarized as pooled odds ratios (pOR) for disease outcomes with 95% confidence intervals (95% CI). Sixteen systematic reviews investigating the possible associations of comorbidities with severity or death from COVID-19 disease were included. Hospitalization was associated with age > 60 years (pOR 3.50; 95% CI 2.97–4.36), smoking habit (pOR 3.50; 95% CI 2.97–4.36), and chronic pulmonary disease (pOR 2.94; 95% CI 2.14–4.04). Chronic pulmonary disease (pOR 2.82; 95% CI 1.92–4.14), cerebrovascular disease (pOR 2.74; 95% CI 1.59–4.74), and cardiovascular disease (pOR 2.44; 95% CI 1.97–3.01) were likely to be associated with increased risk of critical COVID-19. The highest risk of mortality was associated with cardiovascular disease (pOR 3.59; 95% CI 2.83–4.56), cerebrovascular disease (pOR 3.11; 95% CI 2.35–4.11), and chronic renal disease (pOR 3.02; 95% CI 2.61–3.49). In conclusion, this umbrella systematic review provides a comprehensive summary of meta-analyses examining the impact of patients’ characteristics on COVID-19 outcomes. Elderly patients and those cardiovascular, cerebrovascular, and chronic renal disease should be prioritized for pre-exposure and post-exposure prophylaxis and early treatment.
