Age-Adjusted Associations Between Comorbidity and Outcomes of Covid-19

A Review of the Evidence From the Early Stages of the Pandemic

Dados Bibliográficos

ID22067048
AutoresKate E Mason, Kate Mason (0000-0001-5020-5256, University of Liverpool, autor correspondente), Gillian Maudsley (0000-0003-3584-8610, University of Liverpool), Philip McHale (0000-0002-8560-2291, University of Liverpool), Andy Pennington (0000-0002-3455-8825, University of Liverpool), Jenny Day (0000-0001-8681-9831), J P Day (University of Liverpool), Ben Barr (0000-0002-4208-9475, University of Liverpool)
Ano2021
Volume9
Páginas584182-584182
Data de publicação2021-08-06
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoFrontiers in Public Health (JOURNAL)
Identificadores do periódicoISSN: 2296-2565 • E-ISSN: 2296-2565
EditoraFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.584182
PMID34422736
OpenAlexW3195114996
IdiomaEN
Citações recebidas3
Referências citadas48

Objectives: Early in the COVID-19 pandemic, people with underlying comorbidities were overrepresented in hospitalised cases of COVID-19, but the relationship between comorbidity and COVID-19 outcomes was complicated by potential confounding by age. This review therefore sought to characterise the international evidence base available in the early stages of the pandemic on the association between comorbidities and progression to severe disease, critical care, or death, after accounting for age, among hospitalised patients with COVID-19. Methods: We conducted a rapid, comprehensive review of the literature (to 14 May 2020), to assess the international evidence on the age-adjusted association between comorbidities and severe COVID-19 progression or death, among hospitalised COVID-19 patients – the only population for whom studies were available at that time. Results: After screening 1,100 studies, we identified 14 eligible for inclusion. Overall, evidence for obesity and cancer increasing risk of severe disease or death was most consistent. Most studies found that having at least one of obesity, diabetes mellitus, hypertension, heart disease, cancer, or chronic lung disease was significantly associated with worse outcomes following hospitalisation. Associations were more consistent for mortality than other outcomes. Increasing numbers of comorbidities and obesity both showed a dose-response relationship. Quality and reporting were suboptimal in these rapidly conducted studies, and there was a clear need for additional studies using population-based samples. Conclusions: This review summarises the most robust evidence on this topic that was available in the first few months of the pandemic. It was clear at this early stage that COVID-19 would go on to exacerbate existing health inequalities unless actions were taken to reduce pre-existing vulnerabilities and target control measures to protect groups with chronic health conditions

Comorbidity · Confounding · Diabetes mellitus · Disease · Environmental health · Intensive care medicine · Obesity · Pandemic · Population · Chronic Disease Management Strategies · COVID-19 and healthcare impacts · COVID-19 Clinical Research Studies · Medicine · Gerontology · Internal Medicine