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Risk factors for poor outcomes in hospitalised COVID-19 patients: A systematic review and meta-analysis.
Li, You; Ashcroft, Thulani; Chung, Alexandria; Dighero, Izzie; Dozier, Marshall; Horne, Margaret; McSwiggan, Emilie; Shamsuddin, Azwa; Nair, Harish.
  • Li Y; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Ashcroft T; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Chung A; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Dighero I; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Dozier M; Information Services, University of Edinburgh, Edinburgh, UK.
  • Horne M; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • McSwiggan E; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
  • Shamsuddin A; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Nair H; Usher Institute, University of Edinburgh, Edinburgh, UK.
J Glob Health ; 11: 10001, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1154786
ABSTRACT

BACKGROUND:

Understanding the risk factors for poor outcomes among COVID-19 patients could help identify vulnerable populations who would need prioritisation in prevention and treatment for COVID-19. We aimed to critically appraise and synthesise published evidence on the risk factors for poor outcomes in hospitalised COVID-19 patients.

METHODS:

We searched PubMed, medRxiv and the WHO COVID-19 literature database for studies that reported characteristics of COVID-19 patients who required hospitalisation. We included studies published between January and May 2020 that reported adjusted effect size of any demographic and/or clinical factors for any of the three poor

outcomes:

mortality, intensive care unit (ICU) admission, and invasive mechanical ventilation. We appraised the quality of the included studies using Joanna Briggs Institute appraisal tools and quantitatively synthesised the evidence through a series of random-effect meta-analyses. To aid data interpretation, we further developed an interpretation framework that indicated strength of the evidence, informed by both quantity and quality of the evidence.

RESULTS:

We included a total of 40 studies in our review. Most of the included studies (29/40, 73%) were assessed as "good quality", with assessment scores of 80 or more. We found that male sex (pooled odds ratio (OR) = 1.32 (95% confidence interval (CI) = 1.18-1.48; 20 studies), older age (OR = 1.05, 95% CI = 1.04-1.07, per one year of age increase; 10 studies), obesity (OR = 1.59, 95% CI = 1.02-2.48; 4 studies), diabetes (OR = 1.25, 95% CI = 1.11-1.40; 11 studies) and chronic kidney diseases (6 studies; OR = 1.57, 95% CI = 1.27-1.93) were associated with increased risks for mortality with the greatest strength of evidence based on our interpretation framework. We did not find increased risk of mortality for several factors including chronic obstructive pulmonary diseases (5 studies), cancer (4 studies), or current smoker (5 studies); however, this does not indicate absence of risk due to limited data on each of these factors.

CONCLUSION:

Male sex, older age, obesity, diabetes and chronic kidney diseases are important risk factors of COVID-19 poor outcomes. Our review provides not only an appraisal and synthesis of evidence on the risk factors of COVID-19 poor outcomes, but also a data interpretation framework that could be adopted by relevant future research.
Asunto(s)

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Respiración Artificial / Índice de Severidad de la Enfermedad / COVID-19 / Hospitalización / Unidades de Cuidados Intensivos Tipo de estudio: Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado / Revisiones / Revisión sistemática/Meta análisis Límite: Anciano / Femenino / Humanos / Masculino Idioma: Inglés Revista: J Glob Health Año: 2021 Tipo del documento: Artículo País de afiliación: Jogh.11.10001

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Respiración Artificial / Índice de Severidad de la Enfermedad / COVID-19 / Hospitalización / Unidades de Cuidados Intensivos Tipo de estudio: Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado / Revisiones / Revisión sistemática/Meta análisis Límite: Anciano / Femenino / Humanos / Masculino Idioma: Inglés Revista: J Glob Health Año: 2021 Tipo del documento: Artículo País de afiliación: Jogh.11.10001