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Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis

OBJECTIVE: We aimed to systematically identify the possible risk factors responsible for severe cases. METHODS: We searched PubMed, Embase, Web of science and Cochrane Library for epidemiological studies of confirmed COVID-19, which include information about clinical characteristics and severity of...

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Autores principales: Li, Xinyang, Zhong, Xianrui, Wang, Yongbo, Zeng, Xiantao, Luo, Ting, Liu, Qing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092779/
https://www.ncbi.nlm.nih.gov/pubmed/33939733
http://dx.doi.org/10.1371/journal.pone.0250602
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author Li, Xinyang
Zhong, Xianrui
Wang, Yongbo
Zeng, Xiantao
Luo, Ting
Liu, Qing
author_facet Li, Xinyang
Zhong, Xianrui
Wang, Yongbo
Zeng, Xiantao
Luo, Ting
Liu, Qing
author_sort Li, Xinyang
collection PubMed
description OBJECTIVE: We aimed to systematically identify the possible risk factors responsible for severe cases. METHODS: We searched PubMed, Embase, Web of science and Cochrane Library for epidemiological studies of confirmed COVID-19, which include information about clinical characteristics and severity of patients’ disease. We analyzed the potential associations between clinical characteristics and severe cases. RESULTS: We identified a total of 41 eligible studies including 21060 patients with COVID-19. Severe cases were potentially associated with advanced age (Standard Mean Difference (SMD) = 1.73, 95% CI: 1.34–2.12), male gender (Odds Ratio (OR) = 1.51, 95% CI:1.33–1.71), obesity (OR = 1.89, 95% CI: 1.44–2.46), history of smoking (OR = 1.40, 95% CI:1.06–1.85), hypertension (OR = 2.42, 95% CI: 2.03–2.88), diabetes (OR = 2.40, 95% CI: 1.98–2.91), coronary heart disease (OR: 2.87, 95% CI: 2.22–3.71), chronic kidney disease (CKD) (OR = 2.97, 95% CI: 1.63–5.41), cerebrovascular disease (OR = 2.47, 95% CI: 1.54–3.97), chronic obstructive pulmonary disease (COPD) (OR = 2.88, 95% CI: 1.89–4.38), malignancy (OR = 2.60, 95% CI: 2.00–3.40), and chronic liver disease (OR = 1.51, 95% CI: 1.06–2.17). Acute respiratory distress syndrome (ARDS) (OR = 39.59, 95% CI: 19.99–78.41), shock (OR = 21.50, 95% CI: 10.49–44.06) and acute kidney injury (AKI) (OR = 8.84, 95% CI: 4.34–18.00) were most likely to prevent recovery. In summary, patients with severe conditions had a higher rate of comorbidities and complications than patients with non-severe conditions. CONCLUSION: Patients who were male, with advanced age, obesity, a history of smoking, hypertension, diabetes, malignancy, coronary heart disease, hypertension, chronic liver disease, COPD, or CKD are more likely to develop severe COVID-19 symptoms. ARDS, shock and AKI were thought to be the main hinderances to recovery.
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spelling pubmed-80927792021-05-07 Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis Li, Xinyang Zhong, Xianrui Wang, Yongbo Zeng, Xiantao Luo, Ting Liu, Qing PLoS One Research Article OBJECTIVE: We aimed to systematically identify the possible risk factors responsible for severe cases. METHODS: We searched PubMed, Embase, Web of science and Cochrane Library for epidemiological studies of confirmed COVID-19, which include information about clinical characteristics and severity of patients’ disease. We analyzed the potential associations between clinical characteristics and severe cases. RESULTS: We identified a total of 41 eligible studies including 21060 patients with COVID-19. Severe cases were potentially associated with advanced age (Standard Mean Difference (SMD) = 1.73, 95% CI: 1.34–2.12), male gender (Odds Ratio (OR) = 1.51, 95% CI:1.33–1.71), obesity (OR = 1.89, 95% CI: 1.44–2.46), history of smoking (OR = 1.40, 95% CI:1.06–1.85), hypertension (OR = 2.42, 95% CI: 2.03–2.88), diabetes (OR = 2.40, 95% CI: 1.98–2.91), coronary heart disease (OR: 2.87, 95% CI: 2.22–3.71), chronic kidney disease (CKD) (OR = 2.97, 95% CI: 1.63–5.41), cerebrovascular disease (OR = 2.47, 95% CI: 1.54–3.97), chronic obstructive pulmonary disease (COPD) (OR = 2.88, 95% CI: 1.89–4.38), malignancy (OR = 2.60, 95% CI: 2.00–3.40), and chronic liver disease (OR = 1.51, 95% CI: 1.06–2.17). Acute respiratory distress syndrome (ARDS) (OR = 39.59, 95% CI: 19.99–78.41), shock (OR = 21.50, 95% CI: 10.49–44.06) and acute kidney injury (AKI) (OR = 8.84, 95% CI: 4.34–18.00) were most likely to prevent recovery. In summary, patients with severe conditions had a higher rate of comorbidities and complications than patients with non-severe conditions. CONCLUSION: Patients who were male, with advanced age, obesity, a history of smoking, hypertension, diabetes, malignancy, coronary heart disease, hypertension, chronic liver disease, COPD, or CKD are more likely to develop severe COVID-19 symptoms. ARDS, shock and AKI were thought to be the main hinderances to recovery. Public Library of Science 2021-05-03 /pmc/articles/PMC8092779/ /pubmed/33939733 http://dx.doi.org/10.1371/journal.pone.0250602 Text en © 2021 Li et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Li, Xinyang
Zhong, Xianrui
Wang, Yongbo
Zeng, Xiantao
Luo, Ting
Liu, Qing
Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis
title Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis
title_full Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis
title_fullStr Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis
title_full_unstemmed Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis
title_short Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis
title_sort clinical determinants of the severity of covid-19: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092779/
https://www.ncbi.nlm.nih.gov/pubmed/33939733
http://dx.doi.org/10.1371/journal.pone.0250602
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