Identifying the pre-existing comorbidities on coronavirus disease 2019 (COVID-19) mortality will help in developing the required treatment to COVID-19 infections and promote the survival rate by COVID-19 population. This study focused on comprehensive meta-analysis of COVID-19 mortality in United States during 2020-2021 with 15 pre-existing comorbidities. We collected the data from World Health Organization Coronavirus (COVID-19) Dashboard and the Center for Disease Control COVID Data Tracker. The expected result was the risk of COVID-19 mortality with and without pre-existing comorbidities.
This analysis includes 5,929,020 reported COVID-19 deaths in between 01/01/2020 to 06/26/2021 associated with any one of the 15 comorbidities: Influenza and Pneumonia, Diabetes, Cardiac arrest, Ischemic heart disease, Respiratory distress syndrome, Renal failure, Sepsis, Vascular and unspecified dementia, Chronic lower respiratory diseases, Heart failure, Cardiac arrhythmia, Cerebrovascular diseases, Malignant neoplasms, Obesity and Alzheimer disease. The analyses was performed using python language coding tools. Overall, the population associated with Influenza and Pneumonia infections had a significantly greater mortality (27.7% n=1,641,252) from COVID-19 followed by Diabetes (9.6%, n=568716), Cardiac arrest (7.3%, n=431742), Ischemic heart disease (6.6%, n=389742), Respiratory distress syndrome (6.3%, n=372000), Renal failure (6.1%, n=359988), Sepsis (5.8%, n=344082), Vascular and unspecified dementia (5.8%, n=343410), Chronic lower respiratory diseases (5.3%, n=316092), Heart failure (4.6%, n=273594), Cardiac arrhythmia (4.5%, n=266100), Cerebrovascular diseases (3.0%, n=177684), Malignant neoplasms (2.9%, n=172002), Obesity (2.4%, n=145158) and Alzheimer disease (2.1%, n=127458) Table-1.
The risk of severe COVID-19 in people with Influenza and Pneumonia infections is very high compared to other comorbidities. The impact of respiratory distress syndrome and chronic lower respiratory diseases are relatively small. People with Cardiac, Obesity and Alzheimer disease appear to have a modestly lower risk than respiratory diseases. These provides up-to-date results of influence of pre-existing comorbidities in patients with COVID-19 which will expand the current literature considerably. This shows that respiratory viral infection is the main cause of exacerbations of COVID-19 mortality. A probable hypothesis for the mechanism related to the higher risk of mortality among patients with COVID-19 with pre-existing Influenza and Pneumonia infections may stem from the presence of Influenza induced pro-inflammatory cytokines, impaired lung function, immunomodulatory medications that may interact with viral clearance or pathogenesis. This may lead to higher susceptibility with severe complications of COVID-19 and death.
In conclusion, this study found a higher mortality rate due to COVID-19 in patients with preexisting Influenza and Pneumonia infections compared with those with other comorbidities. These findings advice to develop strategies for the infection prevention and treatment targeting this high-risk population which might improve survival.