COVID-19患者合并症患病率及其与疾病严重程度和死亡率的关系:一项系统综述和荟萃分析

IF 3
Journal of multimorbidity and comorbidity Pub Date : 2025-08-28 eCollection Date: 2025-01-01 DOI:10.1177/26335565251371256
Beyene Zewdu Nigatu, Nigatu Teju Dessie
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引用次数: 0

摘要

背景:冠状病毒病-19 (COVID-19)患者的合并症增加了其对重症的易感性。本系统综述和荟萃分析的目的是评估COVID-19患者合并症的患病率及其与疾病严重程度和死亡率增加的关系。方法:通过PubMed,谷歌Scholar和其他来源对文献进行全面检索,包括相关研究。两位独立作者使用Microsoft Excel提取相关数据,并将其导出到Stata version 17进行meta分析。本综述按照PRISMA(系统评价和荟萃分析首选报告项目)指南进行。通过I2统计、分类变量的亚组分析和连续变量的元回归来评估异质性。通过漏斗图和Egger统计量评估发表偏倚。此外,使用随机效应模型进行荟萃分析,以95% CI估计合并优势比(OR),用于评估合并症与COVID-19严重程度和/或死亡率之间的关联。结果:共纳入62项研究,611,646例患者。COVID-19合并症的总患病率为53.9% (95% CI: 48.4-59.3)。合并症与COVID-19严重程度显著相关。具体来说,高血压(OR: 1.09; 95% CI: 1.03-2.51)、糖尿病(OR: 1.29; 95% CI: 1.07-1.56)和肥胖(OR: 1.61; 95% CI: 1.46-1.76)显著增加了严重COVID-19的几率。此外,高血压(OR: 1.14; 95% CI: 1.02-1.57)、糖尿病(OR: 1.39; 95% CI: 1.17-1.65)、肥胖(OR: 1.24; 95% CI: 1.15-1.32)、慢性肾脏疾病(OR: 1.62; 95% CI: 1.25-2.09)和慢性阻塞性肺疾病(COPD) (OR: 1.23; 95% CI: 1.15-1.32)与COVID-19患者的死亡率显著相关。结论:新冠肺炎患者合并症总患病率略高于既往文献报道,为40.0% ~ 41.1%。合并症增加了严重COVID-19的几率。患有高血压、肥胖或糖尿病的参与者患严重COVID-19的几率显著增加。有必要对有合并症的COVID-19患者进行密切随访。方案注册:该系统评价和荟萃分析研究注册号为CRD42023493170。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prevalence of comorbidities and their association with disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.

Prevalence of comorbidities and their association with disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.

Prevalence of comorbidities and their association with disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.

Prevalence of comorbidities and their association with disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.

Background: Comorbidity among coronavirus disease-19 (COVID-19) patients contributes to increasing their susceptibility to severe illness. The objectives of this systematic review and meta-analysis were to assess the prevalence of comorbidities and their association in increased severity of disease and mortality in COVID-19 patients.

Methods: A thorough search of the literature was conducted using PubMed, Google Scholar, and other sources to include pertinent studies. Two independent authors extracted pertinent data using Microsoft Excel and exported it to Stata version 17 for meta-analysis. This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Heterogeneity was assessed through I2 statistics, subgroup analysis for categorical variables, and meta-regression for continuous variables. Publication bias was assessed through funnel plot and Egger statistics. Furthermore, a meta-analysis was performed using a random-effects model to estimate the pooled odds ratio (OR) with 95% CI, which was used to assess the association between comorbidity and severity and/or mortality of COVID-19.

Results: A total of 62 studies with 611,646 patients were included. The pooled prevalence of comorbidity among COVID-19 was 53.9% (95% CI: 48.4-59.3). Comorbidity was significantly associated with severity of COVID-19. Specifically, hypertension (OR: 1.09; 95% CI: 1.03-2.51), diabetes mellitus (OR: 1.29; 95% CI: 1.07-1.56), and obesity (OR: 1.61; 95% CI: 1.46-1.76) significantly increased the odds of severe COVID-19. Furthermore, hypertension (OR: 1.14; 95% CI: 1.02-1.57), diabetes mellitus (OR: 1.39; 95% CI: 1.17-1.65), obesity (OR: 1.24; 95% CI: 1.15-1.32), chronic kidney diseases (OR: 1.62; 95% CI: 1.25-2.09), and chronic obstructive pulmonary diseases (COPD) (OR: 1.23; 95% CI: 1.15-1.32) were significantly associated with mortality of COVID-19 patients.

Conclusion: The pooled prevalence of comorbidity among COVID-19 was found slightly higher than that reported in previous systematic reviews, which ranged from 40.0% to 41.1%. Comorbidity increased the odds of severe COVID-19. Participants with hypertension, obesity, or diabetes mellitus had significantly increased odds of severe COVID-19. There is a need to have close follow-up of COVID-19 patients who have comorbidity.

Protocol registration: This systematic review and meta-analysis study was registered under the registration number CRD42023493170.

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