Prevalence and Integration of symptoms and comorbidities with age of the SARS-CoV-2 patients: a systematic evaluation and meta-analysis
Background: The COVID-19 affected millions of people, and the patients present a constellation of symptoms and comorbidities. We aimed to estimate the prevalence of reported symptoms and comorbidities and assess the correlation between a series of symptoms and comorbidities and age of the patients' positive in COVID-19. Methods: We performed a systematic review and meta-analysis [PROSPERO registration: CRD42020182677]. Databases [PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer] were searched for clinical studies published from January to April 2020. The pooled prevalence of symptoms and comorbidities were identified using the random effect model, and the multivariable factor analysis was performed to show the correlation between a group of symptoms and comorbidities and age of the COVID-19 patients. Findings: Twenty-nine articles [China (24); Outside of China (5)], with 4,884 COVID-19 patients were included in this study. The meta-analysis investigated 33 symptoms, where fever [84%], cough/dry cough [61%], and fatigue/weakness [42%] were found more prevalent. Out of 43 comorbidities investigated, acute respiratory distress syndrome (ARDS) [61%], hypertension [23%] and diabetes [12%] were the most prevalent comorbid condition. The multivariable factor analysis showed positive association between a group of symptoms and comorbidities, and with the patients' age. For example, the symptoms comprising fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia; and the comorbidities including diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS were positively correlated with the COVID-19 patient's age. Interpretation: Among 19 symptoms and 11 comorbidities investigated, a group of symptoms and comorbidities were found correlated with the patients infected in COVID-19.