• Logo
  • SBMUJournals

Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis

Amir Emami, Fatemeh Javanmardi, Neda Pirbonyeh, Ali Akbari



Introduction: In the beginning of 2020, an unexpected outbreak due to a new corona virus made the headlines all over the world. Exponential growth in the number of those affected makes this virus such a threat. The current meta-analysis aimed to estimate the prevalence of underlying disorders in hospitalized COVID-19 patients.

Methods: A comprehensive systematic search was performed on PubMed, Scopus, Web of science, and Google scholar, to find articles published until 15 February 2020.  All relevant articles that reported clinical characteristics and epidemiological information of hospitalized COVID-19 patients were included in the analysis.

Results: The data of 76993 patients presented in 10 articles were included in this study. According to the meta-analysis, the pooled prevalence of hypertension, cardiovascular disease, smoking history and diabetes in people infected with SARS-CoV-2 were estimated as 16.37% (95%CI: 10.15%-23.65%), 12.11% (95%CI 4.40%-22.75%), 7.63% (95%CI 3.83%-12.43%) and 7.87% (95%CI 6.57%-9.28%), respectively.

Conclusion: According to the findings of the present study, hypertension, cardiovascular diseases, diabetes mellitus, smoking, chronic obstructive pulmonary disease (COPD), malignancy, and chronic kidney disease were among the most prevalent underlying diseases among hospitalized COVID-19 patients, respectively.


Comorbidity; COVID-19; severe acute respiratory syndrome coronavirus 2; Meta-analysis


Tan W, Zhao X, Ma X, Wang W, Niu P, Xu W, et al. A novel coronavirus genome identified in a cluster of pneumonia cases—Wuhan, China 2019− 2020. China CDC Weekly. 2020;2(4):61-2.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-13.

Gorbalenya AE. Severe acute respiratory syndrome-related coronavirus–The species and its viruses, a statement of the Coronavirus Study Group. BioRxiv. 2020.

Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Science China Life Sciences. 2020;63(3):364-74.

Kelvin DJ, Rubino S. Fear of the novel coronavirus. The Journal of Infection in Developing Countries. 2020;14(01):1-2.

Carlos WG, Dela Cruz CS, Cao B, Pasnick S, Jamil S. Novel Wuhan (2019-nCoV) Coronavirus. American journal of respiratory and critical care medicine. 2020;201(4):P7-P8.

Paules CI, Marston HD, Fauci AS. Coronavirus infections—more than just the common cold. Jama. 2020;323(8):707-8.

Livingston E, Bucher K, Rekito A. Coronavirus Disease 2019 and Influenza. JAMA. 2020.

Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. The Lancet. 2020;395(10223):470-3.

Rodríguez-Morales AJ, MacGregor K, Kanagarajah S, Patel D, Schlagenhauf P. Going global-Travel and the 2019 novel coronavirus. Travel medicine and infectious disease. 2020:101578.

Sun K, Chen J, Viboud C. Early epidemiological analysis of the coronavirus disease 2019 outbreak based on crowdsourced data: a population-level observational study. The Lancet Digital Health. 2020.

Kwok KO, Li KK, Chan HH, Yi YY, Tang A, Wei WI, et al. Community responses during the early phase of the COVID-19 epidemic in Hong Kong: risk perception, information exposure and preventive measures. medRxiv. 2020.

Margulis AV, Pladevall M, Riera-Guardia N, Varas-Lorenzo C, Hazell L, Berkman ND, et al. Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: the Newcastle–Ottawa scale and the RTI item bank. Clinical epidemiology. 2014;6:359.

Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. The Lancet Oncology. 2020;21(3):335-7.

Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges. International journal of antimicrobial agents. 2020:105924.

Zhang Jj, Dong X, Cao YY, Yuan Yd, Yang Yb, Yan Yq, et al. Clinical characteristics of 140 patients infected by SARS‐CoV‐2 in Wuhan, China. Allergy. 2020.

Guarner J. Three Emerging Coronaviruses in Two DecadesThe Story of SARS, MERS, and Now COVID-19. American Journal of Clinical Pathology. 2020.

Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. Journal of travel medicine. 2020.

Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology. 2020:200490.

Peng L, Yang W, Zhang D, Zhuge C, Hong L. Epidemic analysis of COVID-19 in China by dynamical modeling. arXiv preprint arXiv:200206563. 2020.

Khan N, Fahad S. Critical Review of the Present Situation of Corona Virus in China. Available at SSRN 3543177. 2020.

Zheng Y-Y, Ma Y-T, Zhang J-Y, Xie X. COVID-19 and the cardiovascular system. Nature Reviews Cardiology. 2020.

Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. International Journal of Infectious Diseases. 2016;49:129-33.

Seys LJM, Widagdo W, Verhamme FM, Kleinjan A, Janssens W, Joos GF, et al. DPP4, the Middle East Respiratory Syndrome Coronavirus Receptor, is Upregulated in Lungs of Smokers and Chronic Obstructive Pulmonary Disease Patients. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2018;66(1):45-53.

Zhang J-j, Dong X, Cao Y-y, Yuan Y-d, Yang Y-b, Yan Y-q, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy.n/a(n/a).

Xia Y, Jin R, Zhao J, Li W, Shen H. Risk of COVID-19 for cancer patients. The Lancet Oncology. 2020.

Favre G, Pomar L, Musso D, Baud D. 2019-nCoV epidemic: what about pregnancies? The Lancet. 2020.

Schwartz DA, Graham AL. Potential Maternal and Infant Outcomes from (Wuhan) Coronavirus 2019-nCoV Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections. Viruses. 2020;12(2).

Lin HT, Xiang YF, Cui TX, Chen JJ. [Online learning-related visual impairment and preventive measures during the 2019 novel coronvirus outbreak]. [Zhonghua yan ke za zhi] Chinese journal of ophthalmology. 2020;56(0):E004.

Okada P, Buathong R, Phuygun S, Thanadachakul T, Parnmen S, Wongboot W, et al. Early transmission patterns of coronavirus disease 2019 (COVID-19) in travellers from Wuhan to Thailand, January 2020. Eurosurveillance. 2020;25(8):2000097.

Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Canadian Journal of Anesthesia. 2020.

Patel A, Jernigan DB, nCo VCDCRT. Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020. MMWR Morbidity and mortality weekly report. 2020;69(5):140-6.

Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Military Medical Research. 2020;7(1).

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 2020.

Li J, Li S, Cai Y, Liu Q, Li X, Zeng Z, et al. Epidemiological and Clinical Characteristics of 17 Hospitalized Patients with 2019 Novel Coronavirus Infections Outside Wuhan, China. medRxiv. 2020.

Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine. 2020.

Xiao-Wei X, Xiao-Xin W, Xian-Gao J, Kai-Jin X, Ling-Jun Y, Chun-Lian M, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ: British Medical Journal (Online). 2020;368.

Wu J, Liu J, Zhao X, Liu C, Wang W, Wang D, et al. Clinical Characteristics of Imported Cases of COVID-19 in Jiangsu Province: A Multicenter Descriptive Study. Clinical Infectious Diseases. 2020.

Kui L, Fang Y-Y, Deng Y, Liu W, Wang M-F, Ma J-P, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chinese medical journal. 2020.

DOI: https://doi.org/10.22037/aaem.v8i1.600

DOI (PDF): https://doi.org/10.22037/aaem.v8i1.600.g748

DOI (HTML): https://doi.org/10.22037/aaem.v8i1.600.g754