Prevalence of comorbidities and their association with mortality in patients with COVID‐19: A Systematic Review and Meta‐analysis

Aims
COVID‐19 is a global pandemic that as of the 4th May has registered over 3 585 711 confirmed cases and 248 780 deaths. This review aims to estimate the prevalence of both cardiometabolic and other co‐morbidities in patients with COVID‐19 infection, and to estimate the increased risk of severity and mortality in people with co‐morbidities.

Materials and Methods
Medline, Scopus and the World Health Organisation (WHO) website for Global research on COVID‐19 were searched from January 2019 up to April 23, 2020. Study inclusion was restricted to English language publications, original articles that reported prevalence of co‐morbidities in individuals with COVID‐19 disease, and case‐series >10 patients. 18 studies were selected for inclusion. Data were analysed using random effects meta‐analysis models.

Results
Eighteen studies with a total of 14 558 individuals were identified. The pooled prevalence for co‐morbidities in patients with COVID‐19 disease was 22.9% (95% CI: 15.8 to 29.9) for hypertension; 11.5% (9.7 to 13.4) for diabetes; and 9.7% (6.8 to 12.6) for cardiovascular disease (CVD). For chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), cerebrovascular disease, and cancer, the pooled prevalences were all less than 4%. With the exception of cerebrovascular disease, all other co‐morbidities had a significantly increased risk for having severe COVID‐19. In addition, the risk of mortality was significantly increased in individuals with CVD, COPD, CKD, cerebrovascular disease, and cancer.

Conclusions
In individuals with COVID‐19, the presence of co‐morbidities (both cardiometabolic and other) is associated with a higher risk of severe COVID‐19 and mortality. These findings have important implications for the public health with regards to risk stratification and future planning.