Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

Abstract

<b><i>Introduction:</i></b> Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients. <b><i>Methods:</i></b> Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as <i>p</i> &#x3c; 0.05. <b><i>Results:</i></b> COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67–2.07; <i>p</i> &#x3c; 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age &#x3c;50 years (RR 15.44: 95% CI 13.02–18.31; <i>p</i> &#x3c; 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04–7.88; <i>p</i> &#x3c; 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39–6.76; <i>p</i> &#x3c; 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20–4.25; <i>p</i> &#x3c; 0.00001), respiratory disease (RR 2.74: 95% CI 2.04–3.67; <i>p</i> &#x3c; 0.00001), diabetes (RR 1.97: 95% CI 1.48–2.64; <i>p</i> &#x3c; 0.00001), hypertension (RR 1.95: 95% CI 1.58–2.40; <i>p</i> &#x3c; 0.00001), and cancer (RR 1.89; 95% CI 1.25–2.84; <i>p</i> = 0.002) but not liver disease (RR 1.64: 95% CI 0.82–3.28; <i>p</i>= 0.16). <b><i>Conclusion:</i></b> Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.