Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic



Mason, Kate E ORCID: 0000-0001-5020-5256, Maudsley, Gillian, McHale, Philip ORCID: 0000-0002-8560-2291, Pennington, Andy ORCID: 0000-0002-3455-8825, Day, Jennifer and Barr, Ben ORCID: 0000-0002-4208-9475
(2021) Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic. Frontiers in Public Health, 9.

WarningThere is a more recent version of this item available.
Access the full-text of this item by clicking on the Open Access link.

Abstract

<jats:p><jats:bold>Objectives:</jats:bold> Early in the COVID-19 pandemic, people with underlying comorbidities were overrepresented in hospitalised cases of COVID-19, but the relationship between comorbidity and COVID-19 outcomes was complicated by potential confounding by age. This review therefore sought to characterise the international evidence base available in the early stages of the pandemic on the association between comorbidities and progression to severe disease, critical care, or death, after accounting for age, among hospitalised patients with COVID-19.</jats:p><jats:p><jats:bold>Methods:</jats:bold> We conducted a rapid, comprehensive review of the literature (to 14 May 2020), to assess the international evidence on the age-adjusted association between comorbidities and severe COVID-19 progression or death, among hospitalised COVID-19 patients – the only population for whom studies were available at that time.</jats:p><jats:p><jats:bold>Results:</jats:bold> After screening 1,100 studies, we identified 14 eligible for inclusion. Overall, evidence for obesity and cancer increasing risk of severe disease or death was most consistent. Most studies found that having at least one of obesity, diabetes mellitus, hypertension, heart disease, cancer, or chronic lung disease was significantly associated with worse outcomes following hospitalisation. Associations were more consistent for mortality than other outcomes. Increasing numbers of comorbidities and obesity both showed a dose-response relationship. Quality and reporting were suboptimal in these rapidly conducted studies, and there was a clear need for additional studies using population-based samples.</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> This review summarises the most robust evidence on this topic that was available in the first few months of the pandemic. It was clear at this early stage that COVID-19 would go on to exacerbate existing health inequalities unless actions were taken to reduce pre-existing vulnerabilities and target control measures to protect groups with chronic health conditions.</jats:p>

Item Type: Article
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 09 Aug 2021 10:41
Last Modified: 18 Jan 2023 21:33
DOI: 10.3389/fpubh.2021.584182
Open Access URL: https://www.frontiersin.org/articles/10.3389/fpubh...
URI: https://livrepository.liverpool.ac.uk/id/eprint/3132905

Available Versions of this Item