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Clinical symptoms, comorbidities and complications in severe and non-severe patients with COVID-19: A systematic review and meta-analysis without cases duplication.
Wang, Zhufeng; Deng, Hongsheng; Ou, Changxing; Liang, Jingyi; Wang, Yingzhi; Jiang, Mei; Li, Shiyue.
  • Wang Z; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China.
Medicine (Baltimore) ; 99(48): e23327, 2020 Nov 25.
Article in English | MEDLINE | ID: covidwho-944497
ABSTRACT

BACKGROUND:

The pandemic of COVID-19 poses a challenge to global healthcare. The mortality rates of severe cases range from 8.1% to 38%, and it is particularly important to identify risk factors that aggravate the disease.

METHODS:

We performed a systematic review of the literature with meta-analysis, using 7 databases to identify studies reporting on clinical characteristics, comorbidities and complications in severe and non-severe patients with COVID-19. All the observational studies were included. We performed a random or fixed effects model meta-analysis to calculate the pooled proportion and 95% confidence interval (CI). Measure of heterogeneity was estimated by Cochran's Q statistic, I index and P value.

RESULTS:

A total of 4881 cases from 25 studies related to COVID-19 were included. The most prevalent comorbidity was hypertension (severe 33.4%, 95% CI 25.4%-41.4%; non-severe 21.6%, 95% CI 9.9%-33.3%), followed by diabetes (severe 14.4%, 95% CI 11.5%-17.3%; non-severe 8.5%, 95% CI 6.1%-11.0%). The prevalence of acute respiratory distress syndrome, acute kidney injury and shock were all higher in severe cases, with 41.1% (95% CI 14.1%-68.2%), 16.4% (95% CI 3.4%-29.5%) and 19.9% (95% CI 5.5%-34.4%), rather than 3.0% (95% CI 0.6%-5.5%), 2.2% (95% CI 0.1%-4.2%) and 4.1% (95% CI -4.8%-13.1%) in non-severe patients, respectively. The death rate was higher in severe cases (30.3%, 95% CI 13.8%-46.8%) than non-severe cases (1.5%, 95% CI 0.1%-2.8%).

CONCLUSION:

Hypertension, diabetes and cardiovascular diseases may be risk factors for severe COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Medicine (Baltimore) Year: 2020 Document Type: Article Affiliation country: Md.0000000000023327

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Medicine (Baltimore) Year: 2020 Document Type: Article Affiliation country: Md.0000000000023327