Risk of mortality in COVID-19 patients: a meta- and network analysis

Area of Science:

• Medical research
• Infectious disease epidemiology
• Clinical biochemistry

Background:

• Predicting COVID-19 patient mortality, intensive care unit (ICU) referral, and death requires understanding hematological/biochemical markers and pre-existing conditions.
• A comprehensive literature review and meta-analysis were conducted to identify key predictors of mortality in COVID-19 survivors versus non-survivors.

Approach:

• A meta/network analysis was performed on 97 observational studies and preprints, including 19,014 COVID-19 patients (14,359 survivors, 4655 non-survivors).
• Statistical analyses were conducted using META-MAR V2.7.0 and PAST software to identify significant differences and risk factors.

Key Points:

• Non-survivors exhibited elevated gamma-glutamyl transferase, creatinine, and neutrophil counts, with decreased lymphocytes, platelets, hemoglobin, and albumin.
• Significant risk factors for non-survival included advanced age, hypertension, and cerebrovascular disease.
• Common complications in non-survivors were heart failure, septic shock, and respiratory failure.

Conclusions:

• Inexpensive biochemical and hematological tests, combined with pre-existing conditions and complications, can effectively estimate COVID-19 mortality risk.
• Specific markers like platelet counts, creatinine, albumin, and blood urea nitrogen levels are associated with ICU admission.
• Lower hemoglobin, lymphocyte, and albumin levels correlate with increased mortality risk in ICU patients.