Risk factors for severe corona virus disease 2019 (COVID-19) patients : a systematic review and meta analysis

Abstract

medRxiv preprint Key PointsQuestion What are the risk factors for severe patients with corona virus disease 2019 ?Findings First in this review and meta-analysis, we found that elderly male patients with a high body mass index, high breathing rate and a combination of underlying diseases were more likely to develop into critically ill patients. second, compared with ordinary patients, severe patients had more significant symptom such as fever and dyspnea. Last, we also found that the laboratory test results of severe patients had more abnormal than non-severe patients.Meaning This review summaried the risk factors of severe COVID-19 patients and aim to provide a basis for early identification of severe patients by clinicians. Abstract:Importance: With the increasing number of infections for COVID-19, the global health resources are deficient. At present, we don't have specific medicines or vaccines against novel coronavirus pneumonia (NCP) and our assessment of risk factors for patients with severe pneumonia was limited. In order to maximize the use of limited medical resources, we should distinguish between mild and severe patients as early as possible.Objective: To systematically review the evidence of risk factors for severe corona virus disease 2019 (COVID-19) patients. Evidence Review:We conducted a comprehensive search for primary literature in All rights reserved. No reuse allowed without permission.was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : medRxiv preprint both Chinese and English electronic bibliographic data bases including China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese Biomedicine Literature Database (CBM-SinoMed), MEDLINE (via PubMed), EMBASE, Cochrane Central Register, and Web of science. The American agency for health research and quality (AHRQ) tool were used for assessing risk of bias. Mata-analysis was undertaken using STATA version 15.0.Results: 20 articles (N=4062 participants) were eligible for this systematic review and meta-analysis. First in this review and meta-analysis, we found that elderly male patients with a high body mass index, high breathing rate and a combination of underlying diseases (such as hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease) were more likely to develop into critically ill patients. second, compared with ordinary patients, severe patients had more significant symptom such as fever and dyspnea. Besides, the laboratory test results of severe patients had more abnormal than non-severe patients, such as the elevated levels of white-cell counts, liver enzymes, lactate dehydrogenase, creatine kinase, c-reactive protein and procalcitonin, etc, while the decreased levels of lymphocytes and albumin, etc.

Risk Factors of the Severity of COVID-19: a Meta-Analysis

“…Among those, we have found fatigue or myalgia, hypertension, and diabetes are significant risk factors that might lead to a critical state of COVID-19 patients. Some previous studies 8,12,13 also reported both diabetes and . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

“…From the random-effect meta-analysis, we conclude fever, cough, and diarrhea are insignificant risk factors for the severity of COVID-19. But a previous meta-analysis 8 published fever as a significant risk factor for the severity of COVID-19.…”

“…The copyright holder for this preprint this version posted May 10, 2020. . https://doi.org/10.1101/2020.04.30.20086744 doi: medRxiv preprint severity of COVID-19 8,10 . Other clinical traits termed as risk factors in the publications are hypertension 11,12 , diabetes 12,13 , and fever 8 .…”

What factors increase the risk of complications in SARS-CoV-2 positive patients? A cohort study in a nationwide Israeli health organization

“…Many conditions highlighted by our analysis have been previously reported [5,6,8] and are part of commonly used at-risk definitions [1,3], including hypertension, obesity, kidney and cardiovascular diseases. We do, however, identify a few additional risk factors, notably depression in patients 18-50 years old and males 65 years or more; and cognitive and neurological disorders in patients 65 years or older.…”

“…Initially, these algorithms have been derived from a quickly growing number of epidemiological characterization studies (e.g., [5,6]), which report the prevalence of various conditions in a population of interest, typically severe COVID-19 patients. These studies provide timely and important information; however, identifying risk factors calls for a comparative analysis, contrasting the prevalence of conditions in case and control populations.…”