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Effects of Sex, Age and Comorbidities on the Risk of Infection and Death Associated with COVID-19: A Meta-Analysis of 47807 Confirmed Cases
19 Pages Posted: 9 Apr 2020
More...Abstract
Background: Evidence for the associations of sex, age and comorbidities on the risk of death and infection caused by 2019-nCoV is not well-established. It was aimed to build a robust evidence by estimating aggregated risk for sex, age and comorbidities on the death and infection cases of COVID-2019.
Methods: Literatures were searched in PubMed and other resources from the inception to March 25, 2020 using keywords as "2019 novel coronavirus" or "2019-nCoV" or "SARS-CoV-2" or "COVID-19" AND "clinical outcomes or death or clinical features". Pooled relative risk (RR) was calculated by random effect model using RevMan software where statistical significance was set as <0.05 (2-sided).
Findings: In total, 21 studies comprising of 47,807 confirmed cases of COVID-19 were included. Male patients were associated with 23% and 81% significantly increased risk of infection and death, respectively as compared to female (64.5% vs 35.5%; RR 1.81; 95% CI: 1.66–1.97; P<0.00001). Patients with≥50 years old were associated with 8.7 folds significantly increased risk of death as compared to the patients with<50 years old (92.9% vs 7.0%; RR 8.69; 95% CI: 4.14–18.27; P<0.00001) but risk of infection was not significantly different between these two age groups. Comorbidities were significantly associated with increased risk of death as thus; hypertension (RR 2.63; 95% CI 2.32-2.98; P<0.00001); diabetes (RR 3.34; 95% CI 2.79-4.0; P<0.00001); respiratory disease (RR 4.14; 95% CI 1.82-9.39; P=0.0007); cardio-cereborovascular disease (RR 5.06; 95% CI 4.13-6.20; P<0.00001); kidney disease (RR 3.59; 95% CI 1.49-8.67; P=0.005) and coronary heart disease (RR 3.84; 95% CI 1.64-8.99; P=0.002).
Interpretation: Adequate protections and interventions for the people≥50 years old having comorbidities should be implemented urgently to reduce the risk of death associated with COVID-19.
Funding Statement: No funding.
Declaration of Interests: The authors declared no conflict of interest.
Ethics Approval Statement: This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines.
Suggested Citation: Suggested Citation