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Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis.

Identifieur interne : 000339 ( Main/Corpus ); précédent : 000338; suivant : 000340

Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis.

Auteurs : Zhaohai Zheng ; Fang Peng ; Buyun Xu ; Jingjing Zhao ; Huahua Liu ; Jiahao Peng ; Qingsong Li ; Chongfu Jiang ; Yan Zhou ; Shuqing Liu ; Chunji Ye ; Peng Zhang ; Yangbo Xing ; Hangyuan Guo ; Weiliang Tang

Source :

RBID : pubmed:32335169

Abstract

BACKGROUND

An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help.

METHODS

The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis.

RESULTS

Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR = 1.76, 95% CI (1.41, 2.18), P < 0.00001; age over 65 years old: OR =6.06, 95% CI(3.98, 9.22), P < 0.00001; current smoking: OR =2.51, 95% CI(1.39, 3.32), P = 0.0006). The proportion of underlying diseases such as hypertension, diabetes, cardiovascular disease, and respiratory disease were statistically significant higher in critical/mortal patients compared to the non-critical patients (diabetes: OR=3.68, 95% CI (2.68, 5.03), P < 0.00001; hypertension: OR = 2.72, 95% CI (1.60,4.64), P = 0.0002; cardiovascular disease: OR = 5.19, 95% CI(3.25, 8.29), P < 0.00001; respiratory disease: OR = 5.15, 95% CI(2.51, 10.57), P < 0.00001). Clinical manifestations such as fever, shortness of breath or dyspnea were associated with the progression of disease [fever: 0R = 0.56, 95% CI (0.38, 0.82), P = 0.003;shortness of breath or dyspnea: 0R=4.16, 95% CI (3.13, 5.53), P < 0.00001]. Laboratory examination such as aspartate amino transferase(AST) > 40U/L, creatinine(Cr) ≥ 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC)<4 × 10

CONCLUSION

Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19.


DOI: 10.1016/j.jinf.2020.04.021
PubMed: 32335169
PubMed Central: PMC7177098

Links to Exploration step

pubmed:32335169

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<name sortKey="Zhou, Yan" sort="Zhou, Yan" uniqKey="Zhou Y" first="Yan" last="Zhou">Yan Zhou</name>
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<name sortKey="Ye, Chunji" sort="Ye, Chunji" uniqKey="Ye C" first="Chunji" last="Ye">Chunji Ye</name>
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<name sortKey="Zhang, Peng" sort="Zhang, Peng" uniqKey="Zhang P" first="Peng" last="Zhang">Peng Zhang</name>
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<name sortKey="Xing, Yangbo" sort="Xing, Yangbo" uniqKey="Xing Y" first="Yangbo" last="Xing">Yangbo Xing</name>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</nlm:affiliation>
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<name sortKey="Guo, Hangyuan" sort="Guo, Hangyuan" uniqKey="Guo H" first="Hangyuan" last="Guo">Hangyuan Guo</name>
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<name sortKey="Tang, Weiliang" sort="Tang, Weiliang" uniqKey="Tang W" first="Weiliang" last="Tang">Weiliang Tang</name>
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<name sortKey="Peng, Fang" sort="Peng, Fang" uniqKey="Peng F" first="Fang" last="Peng">Fang Peng</name>
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<name sortKey="Xu, Buyun" sort="Xu, Buyun" uniqKey="Xu B" first="Buyun" last="Xu">Buyun Xu</name>
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<name sortKey="Zhao, Jingjing" sort="Zhao, Jingjing" uniqKey="Zhao J" first="Jingjing" last="Zhao">Jingjing Zhao</name>
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<name sortKey="Liu, Huahua" sort="Liu, Huahua" uniqKey="Liu H" first="Huahua" last="Liu">Huahua Liu</name>
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<name sortKey="Peng, Jiahao" sort="Peng, Jiahao" uniqKey="Peng J" first="Jiahao" last="Peng">Jiahao Peng</name>
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<nlm:affiliation>Loma Linda University School of Public Health, 24951 Circle Dr, Loma Linda, CA 92354, USA.</nlm:affiliation>
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<name sortKey="Li, Qingsong" sort="Li, Qingsong" uniqKey="Li Q" first="Qingsong" last="Li">Qingsong Li</name>
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<nlm:affiliation>Department of Cardiology, Awati County People's Hospital, No.1 North Jiefang Road, Awati County, Xinjiang Uygur Autonomous Region, 843000, PR China.</nlm:affiliation>
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<name sortKey="Jiang, Chongfu" sort="Jiang, Chongfu" uniqKey="Jiang C" first="Chongfu" last="Jiang">Chongfu Jiang</name>
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<nlm:affiliation>Department of Cardiology, Awati County People's Hospital, No.1 North Jiefang Road, Awati County, Xinjiang Uygur Autonomous Region, 843000, PR China.</nlm:affiliation>
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<name sortKey="Zhou, Yan" sort="Zhou, Yan" uniqKey="Zhou Y" first="Yan" last="Zhou">Yan Zhou</name>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</nlm:affiliation>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China; Shaoxing University School of Medicine, 312000, Shaoxing, Zhejiang, China.</nlm:affiliation>
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<name sortKey="Ye, Chunji" sort="Ye, Chunji" uniqKey="Ye C" first="Chunji" last="Ye">Chunji Ye</name>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</nlm:affiliation>
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<name sortKey="Zhang, Peng" sort="Zhang, Peng" uniqKey="Zhang P" first="Peng" last="Zhang">Peng Zhang</name>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</nlm:affiliation>
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<name sortKey="Xing, Yangbo" sort="Xing, Yangbo" uniqKey="Xing Y" first="Yangbo" last="Xing">Yangbo Xing</name>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</nlm:affiliation>
</affiliation>
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<name sortKey="Guo, Hangyuan" sort="Guo, Hangyuan" uniqKey="Guo H" first="Hangyuan" last="Guo">Hangyuan Guo</name>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</nlm:affiliation>
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<name sortKey="Tang, Weiliang" sort="Tang, Weiliang" uniqKey="Tang W" first="Weiliang" last="Tang">Weiliang Tang</name>
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<nlm:affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China. Electronic address: twl-sxyz@163.com.</nlm:affiliation>
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<title level="j">The Journal of infection</title>
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<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR = 1.76, 95% CI (1.41, 2.18), P < 0.00001; age over 65 years old: OR =6.06, 95% CI(3.98, 9.22), P < 0.00001; current smoking: OR =2.51, 95% CI(1.39, 3.32), P = 0.0006). The proportion of underlying diseases such as hypertension, diabetes, cardiovascular disease, and respiratory disease were statistically significant higher in critical/mortal patients compared to the non-critical patients (diabetes: OR=3.68, 95% CI (2.68, 5.03), P < 0.00001; hypertension: OR = 2.72, 95% CI (1.60,4.64), P = 0.0002; cardiovascular disease: OR = 5.19, 95% CI(3.25, 8.29), P < 0.00001; respiratory disease: OR = 5.15, 95% CI(2.51, 10.57), P < 0.00001). Clinical manifestations such as fever, shortness of breath or dyspnea were associated with the progression of disease [fever: 0R = 0.56, 95% CI (0.38, 0.82), P = 0.003;shortness of breath or dyspnea: 0R=4.16, 95% CI (3.13, 5.53), P < 0.00001]. Laboratory examination such as aspartate amino transferase(AST) > 40U/L, creatinine(Cr) ≥ 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC)<4 × 10</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19.</p>
</div>
</front>
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<Month>Aug</Month>
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<Title>The Journal of infection</Title>
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<Abstract>
<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR = 1.76, 95% CI (1.41, 2.18), P < 0.00001; age over 65 years old: OR =6.06, 95% CI(3.98, 9.22), P < 0.00001; current smoking: OR =2.51, 95% CI(1.39, 3.32), P = 0.0006). The proportion of underlying diseases such as hypertension, diabetes, cardiovascular disease, and respiratory disease were statistically significant higher in critical/mortal patients compared to the non-critical patients (diabetes: OR=3.68, 95% CI (2.68, 5.03), P < 0.00001; hypertension: OR = 2.72, 95% CI (1.60,4.64), P = 0.0002; cardiovascular disease: OR = 5.19, 95% CI(3.25, 8.29), P < 0.00001; respiratory disease: OR = 5.15, 95% CI(2.51, 10.57), P < 0.00001). Clinical manifestations such as fever, shortness of breath or dyspnea were associated with the progression of disease [fever: 0R = 0.56, 95% CI (0.38, 0.82), P = 0.003;shortness of breath or dyspnea: 0R=4.16, 95% CI (3.13, 5.53), P < 0.00001]. Laboratory examination such as aspartate amino transferase(AST) > 40U/L, creatinine(Cr) ≥ 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC)<4 × 10
<sup>9</sup>
/L meant a better clinical status[AST > 40U/L:OR=4.00, 95% CI (2.46, 6.52), P < 0.00001; Cr ≥ 133μmol/L: OR = 5.30, 95% CI (2.19, 12.83), P = 0.0002; hs-cTnI > 28 pg/mL: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; PCT > 0.5 ng/mL: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001;LDH > 245U/L: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; D-dimer > 0.5mg/L: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; WBC < 4 × 10
<sup>9</sup>
/L: OR = 0.30, 95% CI (0.17, 0.51), P < 0.00001].</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19.</AbstractText>
<CopyrightInformation>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation>
</Abstract>
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<LastName>Zheng</LastName>
<ForeName>Zhaohai</ForeName>
<Initials>Z</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China; Department of Cardiology, The Run Run Shaw Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, 310003, Zhejiang, PR China.</Affiliation>
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<Affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y">
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<ForeName>Buyun</ForeName>
<Initials>B</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Zhao</LastName>
<ForeName>Jingjing</ForeName>
<Initials>J</Initials>
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<Affiliation>Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang Province, 312000, PR China; Department of Cardiology, The Run Run Shaw Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, 310003, Zhejiang, PR China.</Affiliation>
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