Charlson comorbidity index and a composite of poor outcomes in COVID-19 patients: A systematic review and meta-analysis

Diabetes Metab Syndr. 2020 Nov-Dec;14(6):2103-2109. doi: 10.1016/j.dsx.2020.10.022. Epub 2020 Oct 28.


Background and aims: The ongoing COVID-19 pandemic is disproportionately affecting patients with comorbidities. Therefore, thorough comorbidities assessment can help establish risk stratification of patients with COVID-19, upon hospital admission. Charlson Comorbidity Index (CCI) is a validated, simple, and readily applicable method of estimating the risk of death from comorbid disease and has been widely used as a predictor of long-term prognosis and survival.

Methods: We performed a systematic review and meta-analysis of CCI score and a composite of poor outcomes through several databases.

Results: Compared to a CCI score of 0, a CCI score of 1-2 and CCI score of ≥3 was prognostically associated with mortality and associated with a composite of poor outcomes. Per point increase of CCI score also increased mortality risk by 16%. Moreover, a higher mean CCI score also significantly associated with mortality and disease severity.

Conclusion: CCI score should be utilized for risk stratifications of hospitalized COVID-19 patients.

Keywords: COVID-19; Charlson comorbidity index; Mechanical ventilation; Mortality; Severity.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 / diagnosis
  • COVID-19 / mortality*
  • COVID-19 / therapy*
  • Comorbidity / trends
  • Hospitalization / trends*
  • Humans
  • Prospective Studies
  • Retrospective Studies
  • Risk Assessment / trends