Comorbidities

This section summarises the evidence for the association between different comorbidities in adults and hospitalisation for COVID-19, severe illness or death.

Key findings:

  • Comorbidities/risk factors most associated with severe disease are smoking, hypertension, cardiovascular disease, diabetes, obesity, stroke, chronic respiratory disease, chronic kidney disease, chronic liver disease, cancer, solid organ transplantation, frailty, severe mental illness, learning difficulties, Down’s Syndrome, neurological conditions and dementia.
  • Rheumatoid arthritis, psoriatic arthritis, lupus and other immunosuppressive conditions are significantly associated with severe disease. There was mixed evidence of any association between steroids, use of immunosuppressant medication, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor type 1 (AT1) antagonists and severe COVID-19 disease but very few studies have investigated this.
  • Most pregnant women will have asymptomatic or mild disease that will not impact on their pregnancy. The risk of hospital admission with COVID-19 is increased in pregnant women with a minority ethnic background. There is emerging evidence that pregnant women may be at greater risk of severe disease requiring admission to intensive care and/or need for invasive ventilation than non-pregnant women, particularly in the third trimester. COVID-19 may increase the risk of pre-term birth and admission to a neonatal care unit.

Link to this part of the evidence review here.

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