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The common risk factors for progression and mortality in COVID-19 patients: a meta-analysis
Li Zhang1, Jie Hou1, Fu-Zhe Ma1
1Department of Nephrology, The First Hospital of Jilin University, Changchun, 130021, Jilin, People's Republic of China.
Insights
Identifying risk factors for severe COVID-19 is crucial. Comorbidities like cerebrovascular disease and clinical signs such as sputum production significantly increase progression and mortality risk in patients with coronavirus disease 2019.
Area of Science:
- Medical research
- Epidemiology
- Public health
Background:
- Coronavirus disease 2019 (COVID-19) has caused a global health emergency.
- Identifying risk factors for COVID-19 severity and mortality is essential.
Purpose of the Study:
- To conduct a meta-analysis identifying risk factors for COVID-19 progression and mortality.
Main Methods:
- Systematic search of PubMed, Embase, and Cochrane Library for studies published before September 29, 2020.
- Inclusion of 34 studies with 344,431 participants investigating risk factors for COVID-19 progression and mortality.
- Meta-analysis to identify associations between various factors and disease outcomes.
Main Results:
- Comorbidities (cerebrovascular disease, chronic kidney disease, coronary heart disease, malignancy) and clinical signs (sputum production, hemoptysis) are associated with increased risk.
- Laboratory findings (increased neutrophils, decreased lymphocytes/platelets, elevated C-reactive protein, alanine aminotransferase, creatine kinase, N-terminal pro-brain natriuretic peptide, total bilirubin) and coinfections are linked to severe disease and mortality.
- Bilateral pneumonia on CT/X-ray is more frequent in severe cases.
Conclusions:
- Several comorbidities, clinical manifestations, laboratory markers, and coinfections are significant risk factors for COVID-19 progression and mortality.
- Early identification of these factors can aid in managing patients with coronavirus disease 2019.
- Further research may refine risk stratification and treatment strategies for COVID-19.
Abstract:
Coronavirus disease 2019 (COVID-19), defined by the World Health Organization (WHO), has affected more than 50 million patients worldwide and caused a global public health emergency. Therefore, there is a recognized need to identify risk factors for COVID-19 severity and mortality. A systematic search of electronic databases (PubMed, Embase and Cochrane Library) for studies published before September 29, 2020, was performed. Studies that investigated risk factors for progression and mortality in COVID-19 patients were included. A total 344,431 participants from 34 studies were included in this meta-analysis. Regarding comorbidities, cerebrovascular disease (CVD), chronic kidney disease (CKD), coronary heart disease (CHD), and malignancy were associated with an increased risk of progression and mortality in COVID-19 patients. Regarding clinical manifestations, sputum production was associated with a dramatically increased risk of progression and mortality. Hemoptysis was a risk factor for death in COVID-19 patients. In laboratory examinations, increased neutrophil count, decreased lymphocyte count, decreased platelet count, increased C-reactive protein (CRP), coinfection with bacteria or fungi, increased alanine aminotransferase (ALT) and creatine kinase (CK), increased N-terminal pronatriuretic peptide (NT-proBNP), and bilateral pneumonia in CT/X-ray were significantly more frequent in the severe group compared with the non-severe group. Moreover, the proportion of patients with increased CRP and total bilirubin (TBIL) was also significantly higher in the deceased group than in the survival group. CVD, CKD, sputum production, increased neutrophil count, decreased lymphocyte count, decreased platelet count, increased CRP, coinfection with bacteria or fungi, increased ALT and CK, increased NT-proBNP, and bilateral pneumonia in CT/X-ray were associated with an increased risk of progression in COVID-19 patients. Moreover, the proportion of patients with increased sputum production, hemoptysis, CRP and TBIL was also significantly higher in the deceased group.
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