Background Exploring the association of coronavirus-2019 disease (COVID-19) mortality with chronic pre-existing conditions may promote the importance of targeting these populations during this pandemic to optimize survival. The objective of this systematic review and meta-analysis is to explore the association of pre-existing conditions with COVID-19 mortality. Methods We searched MEDLINE, OVID databases, SCOPUS, and medrxiv.org for the period December 1, 2019, to May 1, 2020. The outcome of interest was the risk of COVID-19 mortality in patients with and without pre-existing conditions. Comorbidities explored were cardiovascular diseases (coronary artery disease, hypertension, cardiac arrhythmias, and congestive heart failure), chronic obstructive pulmonary disease, type 2 diabetes, cancer, chronic kidney disease, chronic liver disease, and stroke. Two independent reviewers extracted data and assessed the risk of bias. All analyses were performed using random-effects models and heterogeneity was quantified. Results Ten chronic conditions from 19 studies were included in the meta-analysis (n = 61,455 patients with COVID-19; mean age, 61 years; 57% male). Overall the between-study study heterogeneity was medium and studies had low publication bias and high quality. Coronary heart disease, hypertension, congestive heart failure, and cancer significantly increased the risk of mortality from COVID-19. The risk of mortality from COVID-19 in patients with coronary heart disease was 2.4 times as high as those without coronary heart disease (RR= 2.40, 95%CI=1.71-3.37, n=5) and twice as high in patients with hypertension as high as that compared to those without hypertension (RR=1.89, 95%CI= 1.58-2.27, n=9). Patients with cancer also were at twice the risk of mortality from COVID-19 compared to those without cancer (RR=1.93 95%CI 1.15-3.24, n=4), and those with congestive heart failure were at 2.5 times the risk of mortality compared to those without congestive heart failure (RR=2.66, 95%CI 1.58-4.48, n=3). Conclusions COVID-19 patients with all any cardiovascular disease, coronary heart disease, hypertension, congestive heart failure, and cancer have an increased risk of mortality. Tailored infection prevention and treatment strategies targeting this high-risk population are warranted to optimize survival.

中文翻译：

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心血管疾病和其他先前合并症与COVID-19死亡率的关联：系统评价和荟萃分析

背景探讨冠状病毒2019疾病（COVID-19）死亡率与慢性疾病的关联可能会提高在这种大流行期间针对这些人群以优化生存的重要性。该系统评价和荟萃分析的目的是探讨既往疾病与COVID-19死亡率的关系。方法我们在MEDLINE，OVID数据库，SCOPUS和medrxiv.org上搜索了2019年12月1日至2020年5月1日的数据。感兴趣的结果是存在和不存在既往疾病患者的COVID-19死亡风险。探索的合并症包括心血管疾病（冠状动脉疾病，高血压，心律不齐和充血性心力衰竭），慢性阻塞性肺疾病，2型糖尿病，癌症，慢性肾脏病，慢性肝病，和中风。两名独立的审阅者提取了数据并评估了偏见的风险。使用随机效应模型进行所有分析，并对异质性进行量化。结果荟萃分析包括19项研究中的10种慢性病（n = 61,455例COVID-19患者；平均年龄61岁；男性占57％）。总体而言，研究之间的研究异质性中等，研究的出版物偏倚低且质量高。冠心病，高血压，充血性心力衰竭和癌症显着增加了COVID-19致死的风险。冠心病患者死于COVID-19的风险是非冠心病患者的2.4倍（RR = 2.40，95％CI = 1.71-3.37，n = 5），是高血压患者的两倍与没有高血压者相比（RR = 1.89，95％CI ＝ 1.58-2.27，n ＝ 9）。与没有癌症的患者相比，癌症患者的COVID-19死亡风险也为两倍（RR = 1.93 95％CI 1.15-3.24，n = 4），而充血性心力衰竭的患者则为死亡风险的2.5倍与没有充血性心力衰竭的患者相比（RR = 2.66，95％CI 1.58-4.48，n = 3）。结论COVID-19患者患有所有心血管疾病，冠心病，高血压，充血性心力衰竭和癌症，其死亡风险增加。针对该高危人群制定了量身定制的感染预防和治疗策略，可以优化生存率。与没有充血性心力衰竭的患者相比，死亡风险是其五倍（RR = 2.66，95％CI 1.58-4.48，n = 3）。结论COVID-19患者患有所有心血管疾病，冠心病，高血压，充血性心力衰竭和癌症，其死亡风险增加。针对该高危人群制定了量身定制的感染预防和治疗策略，可以优化生存率。与没有充血性心力衰竭的患者相比，死亡风险是其五倍（RR = 2.66，95％CI 1.58-4.48，n = 3）。结论COVID-19患者患有所有心血管疾病，冠心病，高血压，充血性心力衰竭和癌症，其死亡风险增加。针对该高危人群制定了量身定制的感染预防和治疗策略，可以优化生存率。