Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis

Abstract

Objective We aimed to systematically identify the possible risk factors responsible for severe cases. Methods We searched PubMed, Embase, Web of science and Cochrane Library for epidemiological studies of confirmed COVID-19, which include information about clinical characteristics and severity of patients’ disease. We analyzed the potential associations between clinical characteristics and severe cases. Results We identified a total of 41 eligible studies including 21060 patients with COVID-19. Severe cases were potentially associated with advanced age (Standard Mean Difference (SMD) = 1.73, 95% CI: 1.34–2.12), male gender (Odds Ratio (OR) = 1.51, 95% CI:1.33–1.71), obesity (OR = 1.89, 95% CI: 1.44–2.46), history of smoking (OR = 1.40, 95% CI:1.06–1.85), hypertension (OR = 2.42, 95% CI: 2.03–2.88), diabetes (OR = 2.40, 95% CI: 1.98–2.91), coronary heart disease (OR: 2.87, 95% CI: 2.22–3.71), chronic kidney disease (CKD) (OR = 2.97, 95% CI: 1.63–5.41), cerebrovascular disease (OR = 2.47, 95% CI: 1.54–3.97), chronic obstructive pulmonary disease (COPD) (OR = 2.88, 95% CI: 1.89–4.38), malignancy (OR = 2.60, 95% CI: 2.00–3.40), and chronic liver disease (OR = 1.51, 95% CI: 1.06–2.17). Acute respiratory distress syndrome (ARDS) (OR = 39.59, 95% CI: 19.99–78.41), shock (OR = 21.50, 95% CI: 10.49–44.06) and acute kidney injury (AKI) (OR = 8.84, 95% CI: 4.34–18.00) were most likely to prevent recovery. In summary, patients with severe conditions had a higher rate of comorbidities and complications than patients with non-severe conditions. Conclusion Patients who were male, with advanced age, obesity, a history of smoking, hypertension, diabetes, malignancy, coronary heart disease, hypertension, chronic liver disease, COPD, or CKD are more likely to develop severe COVID-19 symptoms. ARDS, shock and AKI were thought to be the main hinderances to recovery.

Anti-SARS-CoV-2 Antibodies Testing in Recipients of COVID-19 Vaccination: Why, When, and How?

“…The evidence garnered so far would not allow for drawing definitive conclusions on this matter, though we hope that our analysis may persuade policymakers, healthcare administrators, clinicians, and even laboratory professionals to establish multidisciplinary teams that are aimed at defining the local cost-effectiveness of post-COVID-19 vaccination serosurveillance campaigns. A possible good sense solution encompasses the identification of cohorts to be prioritized for testing, e.g., those at higher risk of being infected by VOCs, or those in whom vaccine immunogenicity appears lower and/or shorter, such as older men, subjects with a high body mass index or undergoing immunosuppressive treatments, and patients with cancer or severe impairment of renal function, who are also at higher risk of developing more severe forms of COVID-19 illness (Table 2) [66]. Notably, the recent claim made by the WHO stating that international COVID-19 trials shall be restarted with more focus on immune response provides significant support to targeted anti-SARS-CoV-2 antibodies testing for assessing the effectiveness of existing treatments, thus including vaccinations [67].…”

Prevalence and prognostic value of gastroenterological manifestations of COVID-19: data from the Russian University Clinic

“…(2021 г. ), обобщившем результаты 41 исследования (n=21 060), было показано, что СД являлся предиктором тяжелого течения COVID-19 (ОШ 2,40, 95% ДИ 1,98-2,91) [36]. Аналогично в другой метааналитической работе также было выявлено, что СД является фактором риска неблагоприятного течения заболевания (ОШ 3,27, 95% ДИ 2,24-4,79) и смерти (ОШ 2,60, 95% ДИ 2,03-3,34) [37].…”

SARS-CoV-2 variants and environmental effects of lockdowns, masks and vaccination: a review

“…Because of existing health inequities linked to socioeconomic factors, some groups may be disproportionately affected by COVID-19 (Niedzwiedz et al 2020 ). In addition to heart failure and cardiomyopathy, other medical conditions that may increase the risk of serious illness from different variants of SARS-CoV-2 include sickle cell disease, thalassemia, pregnancy, chronic liver disease and chronic lung diseases such as cystic or pulmonary fibrosis (Li et al 2021 ).…”