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Published on: November 10, 2023
Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis
Changcheng Shi1, Limin Wang2, Jian Ye2
1Department of Clinical Pharmacy, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
Identifying COVID-19 mortality predictors is crucial for patient outcomes. Advanced age, male sex, comorbidities, dyspnea, and abnormal lab results are key risk factors for fatal outcomes in coronavirus disease 2019.
Area of Science:
- Epidemiology
- Clinical Medicine
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) presents a significant mortality risk, particularly in severe cases.
- Understanding predictors of mortality is essential for effective clinical management.
Purpose of the Study:
- To systematically review and meta-analyze potential predictors of mortality in patients diagnosed with COVID-19.
Main Methods:
- Searched multiple databases (PubMed, EMBASE, Cochrane, Chinese databases) from December 2019 to April 2020.
- Included 36 observational studies, with 27 selected for meta-analysis.
- Pooled unadjusted prognostic estimates using random-effects models and analyzed adjusted estimates qualitatively.
Main Results:
- Identified 106 potential risk factors, confirming advanced age, male sex, smoking, and comorbidities (kidney, respiratory, cardiovascular) as significant predictors.
- Dyspnea, hospitalization complications, corticosteroid use, and severe condition were associated with increased mortality.
- Abnormalities in hematologic, hepatorenal, inflammatory, coagulation, and cardiovascular biomarkers also correlated with fatal outcomes.
Conclusions:
- Key predictors of COVID-19 mortality have been identified.
- Findings can guide healthcare providers in implementing targeted interventions to improve patient outcomes.
Background:
Coronavirus disease 2019 (COVID-19) is associated with a high mortality rate, especially in patients with severe illness. We conducted a systematic review and meta-analysis to assess the potential predictors of mortality in patients with COVID-19.
Methods:
PubMed, EMBASE, the Cochrane Library, and three electronic Chinese databases were searched from December 1, 2019 to April 29, 2020. Eligible studies reporting potential predictors of mortality in patients with COVID-19 were identified. Unadjusted prognostic effect estimates were pooled using the random-effects model if data from at least two studies were available. Adjusted prognostic effect estimates were presented by qualitative analysis.
Results:
Thirty-six observational studies were identified, of which 27 were included in the meta-analysis. A total of 106 potential risk factors were tested, and the following important predictors were associated with mortality: advanced age, male sex, current smoking status, preexisting comorbidities (especially chronic kidney, respiratory, and cardio-cerebrovascular diseases), symptoms of dyspnea, complications during hospitalization, corticosteroid therapy and a severe condition. Additionally, a series of abnormal laboratory biomarkers of hematologic parameters, hepatorenal function, inflammation, coagulation, and cardiovascular injury were also associated with fatal outcome.
Conclusion:
We identified predictors of mortality in patients with COVID-19. These findings could help healthcare providers take appropriate measures and improve clinical outcomes in such patients.
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