Predictors of adverse prognosis in COVID‐19: A systematic review and meta‐analysis

Abstract

Background: Identification of reliable outcome predictors in coronavirus disease 2019 (COVID-19) is of paramount importance for improving patient's management. Methods: A systematic review of literature was conducted until 24 April 2020. From 6843 articles, 49 studies were selected for a pooled assessment; cumulative statistics for age and sex were retrieved in 587 790 and 602 234 cases. Two endpoints were defined: (a) a composite outcome including death, severe presentation, hospitalization in the intensive care unit (ICU) and/or mechanical ventilation; and (b) in-hospital mortality. We extracted numeric data on patients' characteristics and cases with adverse outcomes and employed inverse variance random-effects models to derive pooled estimates. Results: We identified 18 and 12 factors associated with the composite endpoint and death, respectively. Among those, a history of CVD (odds ratio (OR) = 3.15, 95% confidence intervals (CIs) 2.26-4.41), acute cardiac (OR = 10.58, 5.00-22.40) or kidney (OR = 5.13, 1.78-14.83) injury, increased procalcitonin (OR = 4.8, 2.034-11.31) or D-dimer (OR = 3.7, 1.74-7.89), and thrombocytopenia (OR = 6.23, 1.031-37.67) conveyed the highest odds for the adverse composite endpoint. Advanced age, male 2 of 15 | FIGLIOZZI et aL.

The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020

“…Chronic renal disease was not associated with ICU admission, though it was the comorbidity with the highest risk of death and its association with mortality has been highlighted elsewhere [45]. Cardiovascular disease was a consistent risk factor across all severe outcomes [46], even though it was not the strongest one.…”

Comprehensive analysis of COVID-19 during pregnancy

“…The breadth of SARS-CoV-2 infection severity ranges from no symptoms to critical illness that can result in pneumonia and respiratory failure [ 2 ]. Several risk factors for severe COVID-19 disease have been identified, including age (≥50 years old), male sex, and comorbidities such as hypertension, diabetes mellitus, and cardiovascular disease [ 3 ].…”

“…Pregnancy enhances the risk of thromboembolic complications due to the increased levels of coagulation factors in the blood [ 20 ]. Increased D-dimer concentration in COVID-19 patients, indicating degradation of a blood clot, correlates with poorer outcomes [ 3 ]. COVID-19 may further enhance hypercoagulability in pregnant individuals, putting them at even greater risk for thromboembolism [ 20 ].…”

Probabilities of ICU Admission and Hospital Discharge According to Patient Characteristics in the Designated COVID-19 Hospital of Kuwait

“…Two studies in Qatar and Kuwait, specifically focusing on ICU admission, stressed the increased risk associated with DM [24], in contrast with our results, findings in the literature are quite heterogeneous. Actually, meta-analyses found that DM was associated with higher risk of composite event combining ICU admission with mortality and/or severe/critical form of the disease [25,26,27], while other meta-analyses found an absence of increased ICU risk [28,29] or the evidence inconclusive [30]. Furthermore, to our knowledge, most studies did not account for the time component in their analysis and none used a flexible model.…”