Investigation of the Effect of Comorbidity on Mortality in Patients with COVID-19: A Systematic Review and Meta-Analysis

Abstract

Comorbidity is the coexistence of two or more diseases in a certain period. Severe COVID-19 can occur in healthy individuals of any age but predominantly in adults of advanced age or with underlying medical comorbidity. Comorbidities are identified as the main determinants of poor outcomes. This meta-analysis aims to examine the effect of comorbidity on mortality in patients with a diagnosis of COVID-19. Materials and Methods: The studies published between 2019-2020 from Google Scholar, Pub Med, Medline, Scopus, Science Direct, and Web of Science databases were scanned. Inter-rater agreement was calculated with Kappa statistics, effect size "Odds Ratio", heterogeneity between studies with Cochran's Q statistics. The study's effect size and publication bias included in the meta-analysis were calculated using the CMA 3 (Comprehensive Meta-Analysis) program. Results: A total of 24 studies were included in the study. According to the random-effects model, the overall effect size of comorbid factors on mortality development in patients diagnosed with COVID-19 was found to be statistically significant with a value of 2.537 (G.A; 2.078-2.098; p <0.05). In conclusion, cancers, chronic respiratory diseases, diabetes, hypertension, and especially cardiovascular comorbidities are important risk factors for COVID-19 related mortality for COVID-19. There are controversial results in the literature; Further studies involving larger patient groups and examining the specific impact of certain comorbid conditions are needed in order to reach more precise conclusions.