Effect of Comorbidities on the Mortality of Patients With COVID‐19: A Systematic Review of Reviews and Meta‐Analyses
Karla Larissa Trassi Ganaza‐Domingues, Áquila Carolina Fernandes Herculano Ramos‐Milaré, Daniele Stéfanie Sara Lopes Lera‐Nonose, Aline Ávila Brustolin, Larissa Ferreira de Oliveira, Jonathan Sanches Rosa, Allyson Yuiti Otofuji Inada, Amanda Larissa Dias Leme, Beatriz Ignácio Pinel, Brenda Serenini Perina, Mariana de Souza Terron Monich, Thaís da Silva Santos, Izabel Galhardo Demarchi, Maria Valdrinez Campana Lonardoni, Jorge Juarez Vieira Teixeira
Abstract
Studies with strong scientific evidence have demonstrated that comorbidities are associated with fatal outcomes in patients with SARS-CoV-2 infection. To aggregate the findings of these studies and assess the magnitude of the effect of different chronic diseases on COVID-19 mortality, we conducted a systematic review of reviews and meta-analysis. Six databases were searched to retrieve systematic reviews with meta-analysis published during the early years of the pandemic. Statistical analysis was performed using Stata v.12.0 software, and the risk ratio (RR) and odds ratio (OR), with a confidence interval of 95% (95% CI), were calculated. We selected 15 publications with 476 original articles and 2,135,888 patients. Our results indicated the following risk factors for COVID-19 mortality: diabetes mellitus (RR = 1.95; 95% CI:1.41-2.49); hypertension (RR = 1.88; 95% CI:1.51-2.26); cancer (RR = 1.84; 95% CI:1.24-2.43); cardiovascular (RR = 2.14; 95% CI:1.66-2.63), cerebrovascular (RR = 2.43; 95% CI:2.15-2.72), kidney (RR = 2.39; 95% CI:1.36-3.42), pulmonary (RR = 1.98; 95% CI:1.48-2.47) and liver diseases (OR = 1.56; 95% CI:1.18-1.94); obesity (OR = 1.15; 95% CI:1.04-1.26); smoking habits (OR = 1.18; 95% CI:1.13-1.22); and the male sex (OR = 1.69; 95% CI:1.65-1.73). Evidence has confirmed that underlying chronic conditions, which involve an imbalance in the immune response, significantly increase the risk of COVID-19 deaths.