Pre-Existing Diseases Linked to SARS-CoV-2 Morality: A Comparative Study of Global Burden of Disease in Low- Middle and High Income Countries

Introduction: Global burden of disease(GBD) delineates the burden of the diseases prevalent in the countries while Case Fatality Rate (CFR) helps in understanding the severity of the disease.SARS-CoV-2 mortality has been linked to co-morbities. Aim: To assess the association of SARSCoV-2 CFR with Disability Adjusted Life Years (DALY) of various morbidities in the Low-Middle Income Countries and High-Income Countries. Methods: Our study analysed 177 countries data that were stratified in two groups on the basis of Gross Domestic Product as – Low Income and High-Income Groups. The CFR was calculated and analysed using Pearson correlation and Linear regression. Results: The median global case fatality rate of SARS CoV -2 was 2.15. The median CFR among Low-Middle Income Countries (N-60) and High Income Countries(N=117) were 2.01(0.00-28.20) and 2.29(0.00- 17.26) respectively. The regression analysis found that in low- middle income and high income countries, the burden of maternal disorders were associated with higher SARS CoV-2 CFR while Tuberculosis, Mental health disorders & substance abuse were associated with lower SARS CoV-2 CFR. In low-middle income countries, musculoskeletal disorders and nutritional deficiencies were associated with higher CFR while respiratory disorders were associated with lower CFR. In High Income Countries, burden of neurological disorders and other NCDs were also associated with higher CFR while Malaria & neglected tropical diseases and Neonatal disorders had an associated with lower CFR. Conclusion: The SARCoV-2 appears to be a systemic disease with implications on major health systems and associated with co-morbidities not only Non-Communicable disease but also Communicable diseases.Funding Statement: None.Declaration of Interests: None.Ethics Approval Statement: As the study involved secondary data analysis from publicly available free datasets, ethical permission was not necessary.