Preparing for Disease X requires CLARITY, Lessons learned from COVID-19: A systematic review

ObjectivesThe COVID-19 pandemic has highlighted the critical need for comprehensive preparedness strategies for future pandemics, particularly those caused by unknown pathogens, or Disease X. Study DesignOur systematic review examined current literature on COVID-19 risk factors, identifying significant gaps and inconsistencies in data reporting. MethodsA systematic literature search was conducted including all English language published retrospective and prospective observational studies which documented clinical outcomes of COVID-19 in adult patients, on Ovid MEDLINE(R) and Epub databases (December 2019 to March 2023). ResultsThe search yielded 440 articles of which 29 were included in the systematic review. We identified major risk factors for severe outcomes. However, inconsistencies in reporting comorbidities, age, disease control levels, medication use, vaccination status, and variant type, limited our analysis. In many publications, this information was not included. Additionally, variations in public attitudes, knowledge, and behaviours regarding COVID-19 vaccines further complicated resource distribution. We propose the CLARITY model to address these gaps by standardizing risk factor reporting, encompassing detailed comorbidity profiles, disease control metrics, age analyses, medication and vaccination data, and variant-specific information. ConclusionsImplementing the CLARITY model could improve preparedness and response strategies for Disease X, enabling healthcare professionals and systems to allocate resources more effectively and mitigate the impact of future pandemics. This review underscores the necessity for a coordinated global effort to enhance pandemic preparedness through improved data reporting and risk stratification. FundingThis study received financial support from Moderna Biopharma Canada Corporation. Trial RegistrationPROSPERO Identifier CRD42023449647