Factors associated with mortality in COVID-19 patients: A systematic review and meta-analysis

Chidambaram, V and Tun, N.L and Haque, W.Z and Gilbert Majella, M and Kumar Sivakumar, R and Kumar, A and Hsu, A.T.-W and Ishak, I.A and Nur, A.A and Ayeh, S.K and Salia, E.L and Zil-E-Ali, A and Saeed, M.A and Sarena, A.P.B and Seth, B and Ahmadzada, M and Haque, E.F and Neupane, P and Wang, K.-H and Pu, T.-M and Ali, S.M.H and Arshad, M.A and Wang, L and Baksh, S and Karakousis, P.C and Galiatsatos, P (2020) Factors associated with mortality in COVID-19 patients: A systematic review and meta-analysis. PLoS ONE, 15 (11). ISSN 19326203

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Background Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID-19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45, 95% CI 1.23–1.71), dyspnea (RR 2.55, 95%CI 1.88–2.46), diabetes (RR 1.59, 95%CI 1.41–1.78), hypertension (RR 1.90, 95%CI 1.69–2.15). Congestive heart failure (OR 4.76, 95%CI 1.34–16.97), hilar lymphadenopathy (OR 8.34, 95%CI 2.57–27.08), bilateral lung involvement (OR 4.86, 95%CI 3.19–7.39) and reticular pattern (OR 5.54, 95%CI 1.24–24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.

Item Type: Article
Subjects: QW Microbiology and Immunology
WC Communicable Diseases
Divisions: Faculty of Medicin > Department of Internal Medicine
Depositing User: خدیجه شبانکاره
Date Deposited: 20 Dec 2020 09:13
Last Modified: 20 Dec 2020 09:13
URI: http://eprints.bpums.ac.ir/id/eprint/9023

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