TY - JOUR
T1 - Factors associated with disease severity and mortality among patients with COVID-19
T2 - A systematic review and meta-analysis
AU - Chidambaram, Vignesh
AU - Tun, Nyan Lynn
AU - Haque, Waqas Z.
AU - Gilbert Majella, Marie
AU - Kumar Sivakumar, Ranjith
AU - Kumar, Amudha
AU - Hsu, Angela Ting Wei
AU - Ishak, Izza A.
AU - Nur, Aqsha A.
AU - Ayeh, Samuel K.
AU - Salia, Emmanuella L.
AU - Zil-E-Ali, Ahsan
AU - Saeed, Muhammad A.
AU - Sarena, Ayu P.B.
AU - Seth, Bhavna
AU - Ahmadzada, Muzzammil
AU - Haque, Eman F.
AU - Neupane, Pranita
AU - Wang, Kuang Heng
AU - Pu, Tzu Miao
AU - Ali, Syed M.H.
AU - Arshad, Muhammad A.
AU - Wang, Lin
AU - Baksh, Sheriza
AU - Karakousis, Petros C.
AU - Galiatsatos, Panagis
N1 - Publisher Copyright:
© 2020 Chidambaram et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/11
Y1 - 2020/11
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85096407984&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85096407984&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0241541
DO - 10.1371/journal.pone.0241541
M3 - Review article
C2 - 33206661
AN - SCOPUS:85096407984
SN - 1932-6203
VL - 15
JO - PLoS One
JF - PLoS One
IS - 11 November
M1 - e0241541
ER -