Risk of severe outcomes from COVID-19 in comorbid populations in the Omicron era: A systematic review and meta-analysis

Abstract

Objectives This is the first meta-analysis assessing mortality and hospitalization risk from COVID-19 in individuals with comorbidities versus those without during the Omicron era. Methods A systematic search (Embase, MEDLINE, PubMed, Europe PMC, Latin American and Caribbean Health Sciences Literature, Cochrane COVID-19 Study Register, WHO COVID-19 Database) identified studies published between January 2022 and March 2024. Studies included people with at least one of the following comorbidities: cardiovascular/cerebrovascular disease, chronic lung conditions, diabetes, and obesity. Studies were synthesized quantitatively using random-effect models. Evaluated outcomes were risk of death, hospitalization, intensive care unit (ICU) admission, and any combination of these outcomes. Results Of 72 studies, 68 were meta-analyzed. Participant numbers per comorbidity ranged from 328,870 to 13,720,480. Risks of death, hospitalization, and the combined outcome were increased in individuals with cerebrovascular disease, chronic obstructive pulmonary disease, diabetes, respiratory diseases, heart disease, and heart failure (pooled relative risk [RR] range: 1.27 [heart disease, hospitalization; 95% CI: 1.17-1.38] to 1.78 [heart failure, death: 95% CI: 1.46-2.16]). Diabetes and obesity were associated with increased ICU admission risk (RR: 1.20, 95% CI: 1.04-1.38; RR: 1.32, 95% CI: 1.11-1.57, respectively). Conclusion During the Omicron era, individuals with comorbidities faced increased risks of severe outcomes from COVID-19.