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Which groups of patients are at highest risk from COVID-19 infection?

To date there has been no systematic evaluation of the extent to which common co-morbidities increase patient’s risk of disease progression when infected with COVID-19.

However, a recent meta-analysis has provided a quantitative assessment of the risks of various comorbidities among those infected with COVID-19. Researchers undertook a literature review up to 1 March 2020 which identified six studies including 1558 patients with COVID-19, of which 324 (20.8%) were severe and the risk of disease progression was expressed in terms of the odds ratio (OR).

The results indicated that patients with COPD had a 5.9-fold higher risk (OR = 5.97) of disease progression compared to those without the condition. There was a lower but still significant risk of disease aggravation in patients with cardiovascular disease (OR = 2.93), diabetes (OR = 2.47) and hypertension (OR = 2.29).

In contrast, there did not appear to be a correlation between liver or kidney disease and malignant tumours. A noted limitation of the data was the small sample size and the fact that many patients had more than one co-morbidity which may indicate that the risks were under-estimated.

Nevertheless, these data are of value in the development of strategies to minimise the risks for these patient groups.

Wang B et al. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging 2020;12(7):6049-57.