Effect modification of the association between comorbidities and severe course of COVID-19 disease by age of study participants: a systematic review and meta-analysis.
Effect modification of the association between comorbidities and severe course of COVID-19 disease by age of study participants: a systematic review and meta-analysis.
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DOI：
10.1186/s13643-021-01732-3
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发表时间：
2021-06-30
影响因子：
3.7
通讯作者：
Lange B
中科院分区：
文献类型：
--
作者：
Fernández Villalobos NV;Ott JJ;Klett-Tammen CJ;Bockey A;Vanella P;Krause G;Lange B
需要对合并症和行为因素与COVID-19住院、重症监护病房（ICU）入住和死亡之间的关联进行全面的证据综合，以便就非药物干预措施（NPI）的主要目标和疫苗接种策略提出国家和国际建议。我们对研究和可公开获取的数据进行了快速系统回顾和荟萃分析，以量化易患健康状况、人口统计学、行为因素与COVID-19住院、ICU住院和死亡之间的关联。我们通过荟萃分析和荟萃回归提供了报告和计算的效应估计范围以及汇总的相对风险。定性综合纳入75项研究，定量综合纳入74项研究，研究人群从19至44,672例COVID-19病例不等。死于COVID-19的风险与脑血管疾病[综合相对危险度（RR） 2.7 (95% CI 1.7-4.1)]、心血管疾病[RR 3.2 (CI 2.3-4.5)]、高血压[RR 2.6 (CI 2.0-3.4)]和肾脏疾病[RR 2.5 (CI 1.8-3.4)]显著相关，综合估计存在高度异质性，部分但并非完全由研究参与者的年龄解释。对于一些合并症，我们的荟萃回归显示，随着研究人群中位年龄的增加，对疾病严重程度的影响降低。与死亡相比，几种合并症与住院和ICU住院之间的关联不太明显。我们获得了与合并症、人口统计学和行为风险因素相关的COVID-19住院、ICU住院和死亡风险程度的可靠估计，并表明这些估计会随着研究参与者的年龄而改变。对于当前的疫苗接种策略和对COVID-19严重病程高风险个体的保护来说，这种相互作用是一个重要的发现，需要牢记在心。在线版本包含补充材料，可在10.1186/s13643-021-01732-3获得。
Comprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, intensive care unit (ICU) admission, and death due to COVID-19 is required for deriving national and international recommendations on primary targets for non-pharmacological interventions (NPI) and vaccination strategies. We performed a rapid systematic review and meta-analysis on studies and publicly accessible data to quantify associations between predisposing health conditions, demographics, behavioural factors on the one hand and hospitalisation, ICU admission, and death from COVID-19 on the other hand. We provide ranges of reported and calculated effect estimates and pooled relative risks derived from a meta-analysis and meta-regression. Seventy-five studies were included in qualitative and 74 in quantitative synthesis, with study populations ranging from 19 to 44,672 COVID-19 cases. The risk of dying from COVID-19 was significantly associated with cerebrovascular [pooled relative risk (RR) 2.7 (95% CI 1.7–4.1)] and cardiovascular [RR 3.2 (CI 2.3–4.5)] diseases, hypertension [RR 2.6 (CI 2.0–3.4)], and renal disease [RR 2.5 (CI 1.8–3.4)], with high heterogeneity in pooled estimates, partly but not solely explained by age of study participants. For some comorbidities, our meta-regression showed a decrease in effect on the severity of disease with a higher median age of the study population. Compared to death, associations between several comorbidities and hospitalisation and ICU admission were less pronounced. We obtained robust estimates on the magnitude of risk for COVID-19 hospitalisation, ICU admission, and death associated with comorbidities, demographic, and behavioural risk factors and show that these estimates are modified by age of study participants. This interaction is an important finding to be kept in mind for current vaccination strategies and for the protection of individuals with high risk for a severe COVID-19 course. The online version contains supplementary material available at 10.1186/s13643-021-01732-3.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
7.5
作者：
Chen, Qingqing;Zheng, Zhencang;Zheng, Cheng
通讯作者：
Zheng, Cheng
DOI：
10.20452/pamw.15272
发表时间：
2020-04-30
影响因子：
4.8
作者：
Lippi, Giuseppe;Wong, Johnny;Henry, Brandon M.
通讯作者：
Henry, Brandon M.
影响因子：
2.1
作者：
Liu, Ying;Zhang, Jiang;Ji, Yinduo
通讯作者：
Ji, Yinduo
DOI：
10.1097/00043764-197603000-00009
发表时间：
1976-01-01
影响因子：
3.2
作者：
MCMICHAEL, AJ
通讯作者：
MCMICHAEL, AJ