Clinical Characteristics And Risk Factors For Fatal Outcome in Patients With 2019-Coronavirus Infected Disease (COVID-19) in Wuhan, China

Chen, Ming; Fan, Yongzhen; Wu, Xiaoyan; Zhang, Lin; Guo, Tao; Deng, Ke‐Qiong; Cao, Jinxin; Luo, Hesheng; He, Tao; Gong, Yao; Wang, Hairong; Wan, Jing; Wang, Xinghuan; Lu, Zhibing

doi:10.2139/ssrn.3546069

Cited by 39 publications

(39 citation statements)

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“…30 studies were included in the qualitative synthesis and meta-analysis [ Figure 1]. [3,8,[17][18][19][20][21][22][23][24][25][26]9,[27][28][29][30][31][32][33][34][35][36][10][11][12][13][14][15][16] There were a total of 6452 patients from 30 studies.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression

Huang

Lim

Pranata

2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

821

747

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Background and AimsDiabetes Mellitus (DM) is chronic conditions with devastating multi-systemic complication and may be associated with severe form of Coronavirus Disease 2019 . We conducted a systematic review and meta-analysis in order to investigate the association between DM and poor outcome in patients with COVID-19 pneumonia. MethodsSystematic literature search was performed from several electronic databases on subjects that assess DM and outcome in COVID-19 pneumonia. The outcome of interest was composite poor outcome, including mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care, and disease progression. ResultsThere were a total of 6452 patients from 30 studies. Meta-analysis showed that DM was associated with composite poor outcome (RR 2.38 [1.88,3.03], p<0.001; I 2 : 62%) and its subgroup which comprised of mortality (RR 2.12 [1.44, 3.11], p<0.001; I 2 : 72%), severe COVID-19 (RR 2.45 [1.79, 3.35], p<0.001; I 2 : 45%), ARDS (RR 4.64 [1.86,11.58], p=0.001; I 2 : 9%), and disease progression (RR 3.31 [1.08, 10.14], p=0.04; I 2 : 0%). Meta-regression showed that the association with composite poor outcome was influenced by age (p=0.003) and hypertension (p<0.001). Subgroup analysis showed that the association was weaker in studies with median age ≥55 years-old (RR 1.92) compared to <55 years-old (RR 3.48), and in prevalence of hypertension ≥25% (RR 1.93) compared to <25% (RR 3.06). Subgroup analysis on median age <55 years-old and prevalence of hypertension <25% showed strong association (RR 3.33) ConclusionDM was associated with mortality, severe COVID-19, ARDS, and disease progression in patients with COVID-19.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression

Huang

Lim

Pranata

2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

821

747

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“…1). There were a total of 3099 patients from 23 studies [5][6][7][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Baseline characteristics are presented in Table 1.…”

Section: Baseline Characteristics and Study Selectionmentioning

confidence: 99%

Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis

2020

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Objective: Clinical and laboratory biomarkers to predict the severity of coronavirus disease 2019 (COVID-19) are essential in this pandemic situation of which resource allocation must be urgently prepared especially in the context of respiratory support readiness. Lymphocyte count has been a marker of interest since the first COVID-19 publication. We conducted a systematic review and meta-analysis in order to investigate the association of lymphocyte count on admission and the severity of COVID-19. We would also like to analyze whether patient characteristics such as age and comorbidities affect the relationship between lymphocyte count and COVID-19. Methods: Comprehensive and systematic literature search was performed from PubMed, SCOPUS, EuropePMC, ProQuest, Cochrane Central Databases, and Google Scholar. Research articles in adult patients diagnosed with COVID-19 with information on lymphocyte count and several outcomes of interest, including mortality, acute respiratory distress syndrome (ARDS), intensive care unit (ICU) care, and severe COVID-19, were included in the analysis. Inverse variance method was used to obtain mean differences and its standard deviations. Maentel-Haenszel formula was used to calculate dichotomous variables to obtain odds ratios (ORs) along with its 95% confidence intervals. Random-effect models were used for meta-analysis regardless of heterogeneity. Restrictedmaximum likelihood random-effects meta-regression was performed for age, gender, cardiac comorbidity, hypertension, diabetes mellitus, COPD, and smoking. Results: There were a total of 3099 patients from 24 studies. Meta-analysis showed that patients with poor outcome have a lower lymphocyte count (mean difference − 361.06 μL [− 439.18, − 282.95], p < 0.001; I 2 84%) compared to those with good outcome. Subgroup analysis showed lower lymphocyte count in patients who died (mean difference − 395.35 μL [− 165.64, − 625.07], p < 0.001; I 2 87%), experienced ARDS (mean difference − 377.56 μL [− 271.89, − 483.22], p < 0.001; I 2 0%), received ICU care (mean difference − 376.53 μL [− 682.84, − 70.22], p = 0.02; I 2 89%), and have severe COVID-19 (mean difference − 353.34 μL [− 250.94, − 455.73], p < 0.001; I 2 85%). Lymphopenia was associated with severe COVID-19 (OR 3.70 [2.44, 5.63], p < 0.001; I 2 40%). Meta-regression showed that the association between lymphocyte count and composite poor outcome was affected by age (p = 0.034). Conclusion: This meta-analysis showed that lymphopenia on admission was associated with poor outcome in patients with COVID-19.

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“…Table 1 summarizes the most relevant characteristics of the selected studies. Sixteen studies were peer-reviewed [5,6,[12][13][14][15][16][17][18][19][20][21][22][23][24][25] , nineteen were non-peer-reviewed [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] . Not surprisingly, quality assessment revealed a non-high study quality (Supplemental Table 1).…”

Section: Resultsmentioning

confidence: 99%

Prognostic Impact of Coagulopathy in Patients with COVID-19: a Meta-analysis of 35 Studies and 6427 Patients

Polimeni¹,

Leo²,

Spaccarotella³

et al. 2020

Preprint

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Coronavirus Disease 2019 (COVID-19) is a highly contagious disease that appeared in China in December 2019. Several patients with severe COVID-19 infection can develop a coagulopathy according to the ISTH-criteria for disseminated intravascular coagulopathy (DIC). We conducted a meta-analysis of all available studies on COVID-19 to explore the impact of coagulopathy on severe illness and mortality. An electronic search was performed within PubMed, Google Scholar and Scopus electronic databases. The primary endpoint was the difference of D-dimer values between Non-Severe vs Severe disease and Survivors vs Non-Survivors. The primary analysis showed that mean d-dimer is significantly higher in COVID-19 patients with severe disease than in those without (SMD -2.15 [-2.73 to -1.56], I2 98%, P <0.0001). Additional analysis of platelet count showed lower levels of mean PLT in Severe patients than those observed in the Non-Severe patients (SMD 0.77 [0.32 to 1.22], I2 96%, P <0.001). Interestingly, longer mean PT was found in Severe group (SMD -1.34 [-2.06 to -0.62], I2 98%, P <0.0002) compared to Non-Severe group. In conclusion, the results of the present meta-analysis, the largest and most comprehensive to date, demonstrate that Severe COVID-19 infection is associated with higher D-dimer values, lower platelet count and prolonged PT.

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Clinical Characteristics And Risk Factors For Fatal Outcome in Patients With 2019-Coronavirus Infected Disease (COVID-19) in Wuhan, China

Cited by 39 publications

References 0 publications

Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression

Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression

Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis

Prognostic Impact of Coagulopathy in Patients with COVID-19: a Meta-analysis of 35 Studies and 6427 Patients

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