Prevalence of comorbidities among individuals with COVID-19: A rapid review of current literature

Am J Infect Control. 2021 Feb;49(2):238-246. doi: 10.1016/j.ajic.2020.06.213. Epub 2020 Jul 10.


Introduction: On February 11, 2020 WHO designated the name "COVID-19" for the disease caused by "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2), a novel virus that quickly turned into a global pandemic. Risks associated with acquiring the virus have been found to most significantly vary by age and presence of underlying comorbidity. In this rapid literature review we explore the prevalence of comorbidities and associated adverse outcomes among individuals with COVID-19 and summarize our findings based on information available as of May 15, 2020.

Methods: A comprehensive systematic search was performed on PubMed, Medline, Scopus, Embase, and Google Scholar to find articles published until May 15, 2020. All relevant articles providing information on PCR tested COVID-19 positive patient population with clinical characteristics and epidemiological information were selected for review and analysis.

Results: A total of 27 articles consisting of 22,753 patient cases from major epicenters worldwide were included in the study. Major comorbidities seen in overall population were CVD (8.9%), HTN (27.4%), Diabetes (17.4%), COPD (7.5%), Cancer (3.5%), CKD (2.6%), and other (15.5%). Major comorbidity specific to countries included in the study were China (HTN 39.5%), South Korea (CVD 25.6%), Italy (HTN 35.9%), USA (HTN 38.9%), Mexico, (Other 42.3%), UK (HTN 27.8%), Iran (Diabetes 35.0%). Within fatal cases, an estimated 84.1% had presence of one or more comorbidity. Subgroup analysis of fatality association with having comorbidity had an estimated OR 0.83, CI [0.60-0.99], p<0.05.

Conclusions: Based on our findings, hypertension followed by diabetes and cardiovascular diseases were the most common comorbidity seen in COVID-19 positive patients across major epicenters world-wide. Although having one or more comorbidity is linked to increased disease severity, no clear association was found between having these risk factors and increased risk of fatality.

Keywords: Comorbidity; Coronavirus; Epidemiology; Fatality or mortality; Pandemic; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / virology
  • Comorbidity*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / virology
  • Female
  • Global Health / statistics & numerical data*
  • Humans
  • Hypertension / epidemiology*
  • Hypertension / virology
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / virology
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / virology
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / virology
  • SARS-CoV-2*
  • Young Adult