Prevalence of co-morbidities and their association with mortality in patients with COVID-19: A systematic review and meta-analysis

Diabetes Obes Metab. 2020 Oct;22(10):1915-1924. doi: 10.1111/dom.14124. Epub 2020 Jul 16.


Aim: To estimate the prevalence of both cardiometabolic and other co-morbidities in patients with COVID-19, and to estimate the increased risk of severity of disease and mortality in people with co-morbidities.

Materials and methods: Medline, Scopus and the World Health Organization website were searched for global research on COVID-19 conducted from January 2019 up to 23 April 2020. Study inclusion was restricted to English language publications, original articles that reported the prevalence of co-morbidities in individuals with COVID-19, and case series including more than 10 patients. Eighteen 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 the other co-morbidities presented 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 public health with regard to risk stratification and future planning.

Keywords: COVID-19; co-morbidities; coronavirus; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • COVID-19 / complications
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • COVID-19 / pathology*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / pathology
  • Comorbidity
  • Diabetes Complications / mortality
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / mortality
  • Diabetes Mellitus / pathology
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertension / mortality
  • Mortality
  • Neoplasms / complications
  • Neoplasms / epidemiology
  • Neoplasms / mortality
  • Pandemics
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / pathology
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / mortality
  • Risk Factors
  • SARS-CoV-2 / physiology
  • Severity of Illness Index