key: cord-0999021-h0223hb5 authors: Fathi, M.; Vakili, K.; Sayehmiri, F.; Mohamadkhani, A.; Hajiesmaeili, M.; Rezaei-Tavirani, M.; Eilami, O. title: PROGNOSTIC VALUE OF COMORMIDITY FOR SEVERITY OF COVID-19: A SYSTEMATIC REVIEW AND META-ANALYSIS STUDY date: 2020-06-12 journal: nan DOI: 10.1101/2020.06.11.20128835 sha: 9d494df17bf19f1d086577d62f65b4f80409dcf5 doc_id: 999021 cord_uid: h0223hb5 Abstract: Background and Aim: With the increase in the number of COVID-19 infections, global health is facing insufficient sources; this study aimed to provide additional data regarding the clinical characteristics of patients diagnosed with COVID-19 and in particular to analyze the factors associated with disease severity, unimprovement and mortality. Methods: 82 studies were included in the present meta-analysis that all of them have been published before May 1, 2020 and were found by searching through the databases Scopus and MEDLINE. The selected papers were studied and analyzed by employing the version 14 of stata software. It should be noted that, we employed I2 statistics for testing and verifying heterogeneity. Results: 82 papers were finally chosen for this meta- analysis, including 74855 infected patients (35673 men, 31140 women). The mean age of the patients was 56.49. The results indicate the prevalence of fever 79.84 (95% CI: 75.22-84.13), cough 59.53 (95% CI: 55.35-63.65), fatigue or myalgia 33.46 (95% CI: 28.68-38.40), dyspnea 31.48 (95% CI: 25.75-37.49) and diarrhea 10.71 (95% CI: 8.20-13.49). The prevalence of the most common comorbidities were hypertension 25.10 (95% CI: 19.91-30.64), diabetes 13.48 (95% CI: 10.61-16.62), cardiovascular diseases 8.94 (95% CI: 6.99-11.10), and chronic kidney disease 3.27 (95% CI: 2.22-4.47). Conclusion: The results of this study are seriously needed to effectively monitor the health of people with comorbidities (hypertension, diabetes, cardiovascular and cerebrovascular disease, coronary heart disease, and chronic kidney disease) to prevent the development of COVID-19 infection. ) . H u a n g e t a l . e v a l u a t e d t h e c l i n i c a l f e a t u r e s o f 4 1 c a s e s w h o h a d C O V I D -1 9 i n f e c t i o n , a n d t h e i r r e s u l t s h o w e r r e n t l y , w e h a v e n o s p e c i f i c v a c c i n e s o r c u r a t i v e d r u g s a p p r o v e d a g a i n s t t h e n e w C O V I D -1 9 i n f e c t i o n , s o t o p r e v e n t C O V I D -1 9 i n f e c t i o n , a s y s t e m a t i c r e v i e w a n d m e t a -a n a l y s i s h a s b e e n c o n d u c t e d o n a s t u d y o f t h e p r e v a l e n c e o f c o m m o n c o m o r b i d i t i e s b y a n a l y s i s o f c l i n i c a l r i s k f a c t o r s r e s o u r c e f o r C O V I D -1 9 . M e t h o d s S t u d y s e l e c t i o n W e s e a r c h e d P u b M e d a n d S c o p u s d a t a b a s e s t o o b t a i n q u a l i f i e d s t u d i e s t h a t w e r e p u b l i s h e d o n C O V I D -1 9 u n t i l M a y 1 , 2 0 2 0 . T h e k e y w o r d s f o r o u r r e s e a r c h i n c l u d e d : K i d n e y , C O V I D , H y p e r t e n s i o n , D i a b e t e s , ( ( H e a r t ) T h e i r r e f e r e n c e s w e r e a l s o s e a r c h e d i n o r d e r t o c o l l e c t t h o s e t h a t a r e r e l a t e d t o t h e t i t l e . I n c l u s i o n a n d e x c l u s i o n c r i t e r i a A l l s t u d i e s e v a l u a t i n g t h e c l i n i c a l r i s k f a c t o r s , u n d e r l y i n g d i s e a s e s a n d c o m o r b i d i t i e s o f C O V I D -1 9 h a v e b e e n r e v i e w e d . F o r o u r f i n a l a n a l y s i s , t h e s t u d i e s s e l e c t e d s h o u l d r e p o r t d a t a o n t h e p r e v a l e n c e o f e a c h o f t h e r i s k f a c t o r s f o r t h e s e v e r i t y o f C O V I D -1 9 a n d i t s c o m o r b i d i t i e s i n p a t i e n t s w i t h C O V I D -1 9 i n f e c t i o n , i n c l u d i n g h y p e r t e n s i o n , c h r o n i c k i d n e y d i s e a s e , d i a b e t e s , c a r d i o v a s c u l a r a n d c e r e b r o v a s c u l a r d i s e a s e s , a n d c o r o n a r y All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020 . . https://doi.org/10.1101 /2020 h e a r t d i s e a s e . O n l y h u m a n i n v e s t i g a t i o n s w e r e s e l e c t e d . T h e f u l l t e x t s o f t h e r e l e v a n t d o c u m e n t s w e r e a s s e s s e d f o r e x c l u s i o n a n d i n c l u s i o n c r i t e r i a . S t u d i e s t h a t d i d n o t h a v e a d e q u a t e d a t a , n o n -h u m a n s t u d i e s , d u p l i c a t e p u b l i c a t i o n s a n d n o n -E n g l i s h p u b l i c a t i o n s ( e x c e p t t h o s e w i t h u s e f u l a b s t r a c t d a t a ) w e r e e x c l u d e d . D a t a e x t r a c t i o n A l l t h e s e l e c t e d p a p e r s w e r e i n d e p e n d e n t l y e v a l u a t e d a n d s c r e e n e d b y t w o a u (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . https://doi.org/10.1101/2020.06.11.20128835 doi: medRxiv preprint T h i s m e t a -a n a l y s i s i s b a s e d o n d a t a f r o m 8 2 s t u d i e s w i t h l a b o r a t o r y -c o n f i r m e d S A R S -C o V -2 . T h e s e l e c t e d s t u d i e s w e r e f r o m a l l o v e r t h e w o r l d n o t a s p e c i f i c r e g i o n . B a s e d o n p r e v i o u s r e s e a r c h e s o n S A R S -C o V a n d M E R S -C o V , i t i s u n d e r s t o o d t h a t t h e s e v i r u s e s a f f e c t m a l e s m o r e t h a n f e m a l e s ( 2 8 , 2 9 ) . All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . https://doi.org/10.1101/2020.06.11.20128835 doi: medRxiv preprint I n s u m m a r y , t h e r e s u l t s o f t h e c u r r e n t r e v i e w i n d i c a t e d t h a t i n C O V I D -1 9 p a t i e n t s , d i a b e t e s , h y p e r t e n s i o n , c a r d i o v a s c u l a r d i s e a s e , a n d c h r o n i c k i d n e y d i s e a s e a r e t h e m o s t c o m m o n c o m o r b i d i t i e s a n d f e v e r , d i a r r h e All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . e t a l . C l i n i c a l c h a r a c t e r i s t i c s o f c o r o n a v i r u s d i s e a s e 2 0 1 9 i n C h i n a . N e w E n g l a n d j o u r n a l o f m e d i c i n e . 2 0 2 0 . 1 2 . W a n g D , H u B , H u C , Z h u F , L i u X , Z h a n g J , e t a l . C l i n i c a l c h a r a c t e r i s t i c s o f 1 3 8 h o s p i t a l i z e d p a t i e n t s w i t h 2 0 1 9 n o v e l c o r o n a v i r u s -i n f e c t e d p n e u m o n i a i n W u h a n , C h i n a . J a m a . 2 0 2 0 ; 3 2 3 ( 1 1 ) : All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . , Y a n g F , X i a n g L , Z h u J , e t a l . C l i n i c a l c h a r a c t e r i s t i c s o f 2 5 d e a t h c a s e s w i t h C O V I D -1 9 : a r e t r o s p e c t i v e r e v i e w o f m e d i c a l r e c o r d s i n a s i n g l e m e d i c a l c e n t e r , W u h a n , C h i n a . I n t e r n a t i o n a l J o u r n a l o f I n f e c t i o u s D i s e a s e s . 2 0 2 0 . 3 3 . R o d r i g u e z -M o r a l e s A J , C a r d o n a -O s p i n a J A , G u t i é r r e z -O c a m p o E , V i l l a m i z a r -P e ñ a R , H o l g u i n -R i v e r a Y , E s c a l e r a -A n t e z a n a J P , e t a l . . . . All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . https://doi.org/10.1101/2020.06.11.20128835 doi: medRxiv preprint Y a n g Y , Z h a n g C , H u a n g F , W a n g F , Y u a n J , e t a l . C l i n i c a l a n d b i o c h e m i c a l i n d e x e s f r o m 2 0 1 9 -n C o V i n f e c t e d p a t i e n t s l i n k e d t o v i r a l l o a d s a n d l u n g i n j u r y . S c i e n c e C h i n a L i f e S c i e n c e s . 2 0 2 0 ; 6 3 ( 3 ) : 3 6 4 -7 4 . 5 4 . Z h a n g M Q , W a n g X H , C h e n Y L , Z h a o K L , C a i Y Q , A n C L , e t a l . [ C l i n i c a l f e a t u r e s o f 2 0 1 9 n o v e l c o r o n a v i r u s p n e u m o n i a i n t h e e a r l y s t a g e f r o m a f e v e r c l i n i c i n B e i j i n g ] . Z h o n g h u a j i e h e h e h u x i z a z h i = Z h o n g h u a j i e h e h e h u x All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . 9 8 . M e n g Y , W u P , L u W , L i u K , M a K , H u a n g L , e t a l . S e x -s p e c i f i c c l i n i c a l c h a r a c t e r i s t i c s a n d p r o g n o s i s o f c o r o n a v i r u s d i s e a s e -1 9 i n f e c t i o n i n W u h a n , C h i n a : A r e t r o s p e c t i v e s t u d y o f 1 6 8 s e v e r e p a t i e n t s . P L o S p a t h o g e n s . 2 0 2 0 ; 1 6 ( 4 ) : e 1 0 0 8 5 2 0 . 9 9 . L o v e l l N , M a d d o c k s M , E t k i n d S N , T a y l o r K , C a r e y I , V o r a V , e t a l . C h a r a c t e r i s t i c s , s y m p t o m m a n a g e m e n t a n d o u t c o m e s o f 1 All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . https://doi.org/10.1101/2020.06.11.20128835 doi: medRxiv preprint All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . https://doi.org/10.1101/2020.06.11.20128835 doi: medRxiv preprint All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . https://doi.org/10. 1101 /2020 Highlights: • T h e m o s t p r e v a l e n t r i s k f a c t o r s a m o n g p a t i e n t s w i t h C O V I D -1 9 w e r e h y p e r t e n s i o n , d i a b e t e s , c a r d i o v a s c u l a r d i s e a s e , a n d c h r o n i c k i d n e y d i s e a s All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 12, 2020. . https://doi.org/10. 1101 /2020 25.73) 33.94 (28.35, 39.88) 31.99 (29.70, 34.35) 45.45 (33.14, 58.19) 13.66 (8.77, 19.95) 38.30 (24.51, 53.62) 13.04 (6.14, 23.32) 18.52 (6.30, 38.08) 22.22 (6.41, 47.64) 37.65 (27.36, 48.82) 30.29 (26.47, 34.33) 30.53 (26.14, 35.20) 40.00 (5.27, 85.34) 19.40 (14 Fig 2. Forest Plot of the prevalence of hypertension in COVID-19 patients. Each square indicates the effect estimate of individual articles with their 95% CI Size of squares is proportional to the weight of each paper in the metaanalysis. In this plot, papers are indicated in the order of first author's names and publication date (based on a random effects model).