Background: COVID-19 patients usually present multiple comorbidities and complications associated with severe forms of SARS-CoV-2 infection. This study aimed to assess the risk factors and prevalence of comorbidities and complications contributing to the severity of COVID-19.

Methods: This meta-analysis was performed according to PRISMA guidelines. We searched various databases, including PubMed, Google Scholar, and Scopus (between 2020 and 2023), for eligible studies for this meta-analysis.

Results: Thirty-three studies were eligible, including 85812 patients, of which 36% (30634/85812) had severe disease, whereas 64% (55178/85812) had non-severe disease. Severe cases were potentially correlated with the following factors: gender (male) (odd ratio (OR) =1.52, 95% CI: 1.34-1.73), advanced age (OR=3.06, 95% CI: 2.18-4. 40 ) pre-existing smoking (OR =1.33, 95% CI : 1.01-1.75), obesity (OR=2.11, 95% CI : 1.47-3.04), diabetes (OR =1.81 , 95% CI : 1.35 - 2.43), hypertension (OR =2.22, 95% CI : 1. 72-2.87), coronary heart disease (OR=2.17, 95% CI: 1.42-3.31), CKD (OR =2.27, 95% CI: 1.26-4.06), COPD (OR=1.95, 95% CI: 1.22-3.09), malignancy (OR =1.63, 95% CI: 1.07-2.49) and cerebrovascular disease (OR= 2.76, 95% CI: 1.63-4.62). All these comorbidities were significantly higher in the severe COVID-19 group compared with the non-severe COVID-19 group. In addition, the most severe complications were associated with shock (OR=28.08, 95% CI: 3.49 - 226.03), ARDS (OR=13.09, 95% CI: 5.87-29.18), AKI (OR= 16.91, 95% CI: 1.87-152.45) and arrhythmia (OR=7.47, 95% CI: 2.96-18.83). However, these complications were the most likely to prevent recovery in patients with severe affections compared with non-severe affection groups.

Conclusion: All the comorbidities and complications listed above are more likely to cause severe forms of COVID-19 in some patients and hinder recovery. They are therefore risk factors to be controlled to minimize the undesirable effects of the disease.

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This work is licensed under a Creative Commons Attribution 4.0 License.