Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic.
Age-Adjusted Associations Between Comorbidity and Outcomes of COVID-19: A Review of the Evidence From the Early Stages of the Pandemic.
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DOI：
10.3389/fpubh.2021.584182
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发表时间：
2021
影响因子：
5.2
通讯作者：
Barr B
中科院分区：
文献类型：
--
作者：
Mason KE;Maudsley G;McHale P;Pennington A;Day J;Barr B
目的：在 COVID-19 大流行早期，患有潜在合并症的人在 COVID-19 住院病例中所占比例过高，但合并症与 COVID-19 结果之间的关系由于年龄的潜在混杂因素而变得复杂。因此，本次综述旨在描述大流行早期阶段可用的国际证据基础，即在考虑年龄后，住院的 COVID-19 患者中合并症与进展为严重疾病、重症监护或死亡之间的关联。方法：我们对文献进行了快速、全面的回顾（截至 2020 年 5 月 14 日），以评估住院 COVID-19 患者（当时唯一可进行研究的人群）中合并症与严重 COVID-19 进展或死亡之间年龄调整关联的国际证据。结果：筛选 1,100 项研究后，我们确定了 14 项符合纳入条件。总体而言，肥胖和癌症增加严重疾病或死亡风险的证据是最一致的。大多数研究发现，患有肥胖、糖尿病、高血压、心脏病、癌症或慢性肺病中的至少一种与住院后较差的结果显着相关。与其他结果相比，死亡率的关联更为一致。越来越多的合并症和肥胖都显示出剂量反应关系。在这些快速进行的研究中，质量和报告均未达到最佳水平，显然需要使用基于人群的样本进行更多研究。结论：本次审查总结了大流行最初几个月内有关该主题的最有力证据。很明显，在早期阶段，除非采取行动减少现有的脆弱性并采取有针对性的控制措施来保护患有慢性疾病的群体，否则 COVID-19 将继续加剧现有的健康不平等。
Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
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影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
82.9
作者：
Brodin, Petter
通讯作者：
Brodin, Petter
影响因子：
28.2
作者：
Dai, Mengyuan;Liu, Dianbo;Cai, Hongbing
通讯作者：
Cai, Hongbing
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作者：
Davies, HTO;Crombie, IK;Tavakoli, M
通讯作者：
Tavakoli, M
影响因子：
2
作者：
Caniglia G;Jaeger C;Schernhammer E;Steiner G;Russo F;Renn J;Schlosser P;Laubichler MD
通讯作者：
Laubichler MD