Comorbidities and severity of coronavirus disease 2019 patients

Saudi Med J. 2020 Nov;41(11):1165-1174. doi: 10.15537/smj.2020.11.25454.


Objectives: To determine the association between comorbidities and the severity of the disease among COVID-19 patients.

Methods: We searched the Cochrane, Medline, Trip, and EMBASE databases from 2019. The review included all available studies of COVID-19 patients published in the English language and studied the clinical characteristics, comorbidities, and disease outcomes from the beginning of the pandemic. Two authors extracted studies characteristics and the risk of bias. Odds ratio (OR) was used to analyze the data with 95% confidence interval (CI).

Results: The review included 1,885 COVID-19 patients from 7 observational studies with some degree of bias risk and substantial heterogeneity. A significant association was recorded between COVID-19 severity and the following variables: male (OR= 1.60, 95%CI= 1.05 - 2.43); current smoker (OR=2.06, 95%CI= 1.08 - 3.94); and the presence of comorbidities including hypertension (OR=2.05, 95%CI= 1.56 - 2.70), diabetes (OR=2.46, 95%CI= 1.53 - 3.96), coronary heart disease (OR=4.10, 95%CI= 2.36 - 7.12), chronic kidney disease (OR=4.06, 95%CI= 1.45 - 11.35), and cancer (OR=2.28, 95%CI= 1.08 - 4.81).

Conclusions: Comorbidities among COVID-19 patients may contribute to increasing their susceptibility to severe illness. The identification of these potential risk factors could help reduce mortality by identifying patients with poor prognosis at an early stage.

Publication types

  • Review

MeSH terms

  • COVID-19
  • Cause of Death*
  • Comorbidity*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Data Management
  • Disease Susceptibility / epidemiology*
  • Female
  • Humans
  • Incidence
  • Male
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Saudi Arabia / epidemiology
  • Severe Acute Respiratory Syndrome / diagnosis
  • Severe Acute Respiratory Syndrome / epidemiology*
  • Severity of Illness Index
  • Survival Analysis