Features of severe COVID-19: A systematic review and meta-analysis.

Abstract

BACKGROUND:

To systematically review clinical and biochemical characteristics associated with the severity of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19).

MATERIALS AND METHODS:

Systematic review of observational studies from PubMed, ISI Web of Science, SCOPUS and Cochrane databases including people affected by COVID-19 and reporting data according to the severity of the disease. Data were combined with odds ratio (OR) and metanalysed. Severe COVID-19 was defined by acute respiratory distress syndrome, intensive care unit admission and death.

RESULTS:

We included 12 studies with 2794 patients, of whom 596 (21.33%) had severe disease. A slightly higher age was found in severe vs non-severe disease. We found that prevalent cerebrovascular disease (odds ratio [OR] 3.66, 95% confidence interval [CI] 1.73-7.72), chronic obstructive pulmonary disease (OR: 2.39, 95% CI 1.10-5.19), prevalent cardiovascular disease (OR: 2.84, 95% CI 1.59-5.10), diabetes (OR: 2.78, 95% CI 2.09-3.72), hypertension (OR: 2.24, 95% CI 1.63-3.08), smoking (OR: 1.54, 95% CI 1.07-2.22) and male sex (OR: 1.22, 95% CI 1.01-1.49) were associated with severe disease. Furthermore, increased procalcitonin (OR: 8.21, 95% CI 4.48-15.07), increased D-Dimer (OR: 5.67, 95% CI 1.45-22.16) and thrombocytopenia (OR: 3.61, 95% CI 2.62-4.97) predicted severe infection.

CONCLUSION:

Characteristics associated with the severity of SARS-CoV-2 infection may allow an early identification and management of patients with poor outcomes.

• Authors: Francesco Del Sole, Alessio Farcomeni, Lorenzo Loffredo, Roberto Carnevale, Danilo Menichelli, Tommasa Vicario, Pasquale Pignatelli, Daniele Pastori
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 50 Issue 10 Pg. e13378 (Oct 2020) ISSN: 1365-2362 [Electronic] England
• PMID: 32860457 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

Chemical References

• Fibrin Fibrinogen Degradation Products
• Procalcitonin
• fibrin fragment D

Topics

• Betacoronavirus
• COVID-19
• Cardiovascular Diseases (epidemiology)
• Cerebrovascular Disorders (epidemiology)
• Comorbidity
• Coronavirus Infections (epidemiology, metabolism, physiopathology)
• Diabetes Mellitus (epidemiology)
• Fibrin Fibrinogen Degradation Products (metabolism)
• Humans
• Hypertension (epidemiology)
• Pandemics
• Pneumonia, Viral (epidemiology, metabolism, physiopathology)
• Prevalence
• Procalcitonin (metabolism)
• Pulmonary Disease, Chronic Obstructive (epidemiology)
• Risk Factors
• SARS-CoV-2
• Severity of Illness Index
• Sex Factors
• Smoking (epidemiology)
• Thrombocytopenia (epidemiology)