The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

Zhang, Ning; Xie, Tao; Wei, Ning; He, Rongxin; Zhu, Bin; Mao, Ying

doi:10.3390/su13095305

Cited by 14 publications

(17 citation statements)

References 113 publications

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“…Besides, vaccinated individuals had higher frequency of getting discharge with full recovery compared to non-vaccinated patients. These results are also in accordance with the previous studies 201826, 27 Similar The main baseline characteristics of our study were in accordance with studies from previous COVID-19 waves, as maximum study patients were older aged [28][29][30][31][32] ,male [33][34][35] , hypertensive and diabetic [36][37][38] .…”

Section: [Table-1]supporting

confidence: 93%

Comparison of Disease Severity and In-hospital Outcome of COVID-19 among Non-vaccinated versus Vaccinated (1st dose) Hospitalized Patients in a Tertiary Care Hospital: an Observational Study

Rishad

Reza²,

Noor

et al. 2022

Bangla J Med

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Background: COVID-19 vaccines have a high rate of success in averting hospitalization and mortality. However, COVID-19 infection is still being detected among immunized patients, although with blunted severity. This study aimed to compare the severity and outcome of COVID-19 among immunized versus non-immunized individuals. Methods: This cross-sectional study was conducted over 179 COVID-19 patients in Popular Medical College Hospital, Dhaka. All the methods in the present study were carried out following the ethical guidelines of the 1975 Declaration of Helsinki. Data were collected from both hospital record and direct interview. Data were recorded in separated case record form and analyzed by STATA version 14. Results: Mean age of the study patients was 55.42±14.20 (SD) years wherein maximum were male (61.5%). Fever (88.8%), cough (81.6%), dyspnea (47.5%) and sore throat (30.2%) were most common symptoms. Maximum patients werehypertensive (60.9%) and diabetic (58.7%). About 35.8% of patients had mild severity, while 27.9% had moderate, 23.4% had severe, and 12.8% had critical stage. Maximum patients (n=122, 68.2%) were nonvaccinated and rest (n=57, 31.8%) had received 1st dose of vaccine. Vaccinated patients had significantly higher frequency of having mild COVID-19 (57.9% vs 31.1%, p<0.001) and getting discharge with full recovery (94.7% vs 76.2%, p=0.003) compared to non-vaccinated patients. Moreover, non-vaccinated patients were more prone to develop critical clinical syndrome (10.6% vs 1.8%, p=0.039) and had died or referred to higher center (11.4% vs 1.8%, p=0.029) than vaccinated individuals. Conclusion: COVID-19 vaccination was significantly associated with mild severity and lower rate of adverse outcome. Bangladesh J Medicine 2022; 33: 293-299

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Section: [Table-1]supporting

confidence: 93%

Comparison of Disease Severity and In-hospital Outcome of COVID-19 among Non-vaccinated versus Vaccinated (1st dose) Hospitalized Patients in a Tertiary Care Hospital: an Observational Study

Rishad

Reza²,

Noor

et al. 2022

Bangla J Med

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“…Furthermore, the shorter the interval between the mother’s first symptoms and delivery, the higher the risk of vertical transmission [ 36 ]. The studies described the general syndrome as fatigue, fever, respiratory syndrome, and gastrointestinal symptoms, which may be signs of severe disease progression [ 37 ]. The National Institutes of Health (NIH) grouped SARS-CoV-2 infection into the following severity of illness categories: Asymptomatic, mild illness, moderate illness, severe illness, and critical illness [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…If we refer to the laboratory results, the studies describe the subsequent investigation to be used as a potential predictor of the severity of the infection: Albumin, AST, creatinine, D-dimer, fibrinogen, neutrophils, procalcitonin, and platelets [ 37 ]. Another interesting observation is that in severe forms of COVID-19, with oxygen dependence, a significantly higher AST was found but not ALT [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical, Laboratory, and Imaging Findings of Pregnant Women with Possible Vertical Transmission of SARS-CoV-2—Case Series

Craina

Iacob

Dima

et al. 2022

IJERPH

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The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic significantly impacted the general population’s health. At times, the infection has unfavorably influenced pregnancy evolution and the result of birth. However, vertical transmission of the virus is rare and generates controversial discussions. The study aimed to highlight the clinical, laboratory, and imaging findings of pregnant women with confirmed Coronavirus Disease 2019 (COVID-19) with possible vertical transmission and identify possible factors that encourage vertical transmission. Between 1 April 2020 and 31 December 2021, 281 pregnant women diagnosed with COVID-19 gave birth in the Obstetrics and Gynecology Departments of the tertiary unit of County Emergency Clinical Hospital from Timisoara. Three newborns (1.06%) tested positive. The characteristic of these three cases was described as a short series. In two cases, the patients were asymptomatic. In one case, the patient developed a mild form of COVID-19 with a favorable evolution in all cases. We did not identify the presence of smoking history, vaccine before admission, atypical presentation, fever, or chest X-ray abnormalities. We note possible factors that encourage vertical transmission: Pregnancy-induced hypertension, thrombophilia, asymptomatic cough, an asymptomatic or mild form of the disease, a ruptured membrane, and cesarean. The laboratory results highlight the inconstant presence of some changes found in the list of potential predictors of the severity of the infection: Lymphopenia, high values of C-reactive protein, D-dimer, fibrinogen, platelets, Aspartate Aminotransferase, Lactate dehydrogenase, and ferritin. The study’s conclusion of this small group suggests that there may have been an intrauterine infection in late pregnancy and described characteristics of the pregnant women. Possible risk factors that could encourage vertical transmission have been identified.

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“…Each chest X-Ray is then scored using the Brixia score, a semiquantitative scoring system rating lung involvement BJM Vol. 33 No. 3 Pattern of Chest X-rays findings and clinical correlation with the severity in COVID-19 from 0 to 18 and it was evaluated by a radiologist who had experience in radiology for more than ten years.…”

Section: Methodsmentioning

confidence: 99%

Pattern of Chest X-rays findings and clinical correlation with the severity in COVID-19 (RT-PCR positive) infected patients admitted in a COVID-19 dedicated hospital in Bangladesh

Biswas¹,

Chowdhury²,

Majumder³

et al. 2022

Bangla J Med

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Objective: This study aims to analyze Chest X-ray findings in COVID 19(RT-PCR positive) patients, correlate between clinical and radiological findings and short-term outcomes of the patients with the view to enhance clinicians’ understanding of CXR findings in COVID 19 patients. Methods: This descriptive type of observational study included 277 reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed COVID-19 patients who were undergone CXRs, based on the clinician’s decision. Data were collected from May to September 2020 of Maternal and Child Health Training Institute (MCHTI)- a COVID-19 dedicated hospital, Lalkuthi, Mirpur-1, Dhaka and analyzed statistically through SPSS,Version 25. Each chest X-Ray is then scored using the Brixia score, a semi-quantitative scoring system rating lung involvement from 0 to 18 by a radiologist. The scores are then analyzed and compared with the characteristics of the patients, clinical presentation, and short-term outcome (in-hospital & after discharge) to correlate the severity and post covid-19 complications of COVID-19 infected patients. Results: A total of 277 RT-PCR-positive patients were performed chest x-ray P/A view, among them 58.12%(161) were male and 41.88%(116) were female. Age variation was from 6 to 95 years and the mean age was 42.48±15.53(S.D).Most of the patients(94.94%)were symptomatic and the majority(97.9%) of symptomatic patients had comorbidities(p-value 0.02).Among the x-ray performed patients(n=277), 39.35% (109) patients had positive findings suggestive of covid-19 infection. Comorbidities and sex had significant relation on positive x-ray findings(p-value 0.0001 and 0.001);males (70.6%) had more positive findings than females(29.4%).Positive x-ray findings were more common among the age group 41 to 60 years (p-value 0.0001 and Cramer’s V 0.59).Most of the patients (94.49%) had bilateral lungs involvement and consolidations were the commonest x-ray findings (43.1%).Clinical severity was assessed by symptoms and Spo2 level (<91%) and 20.2% were clinically severe (M-23.6%, F-15.5%). Age, comorbidities, and higher Brixia score (>8) had a significant relation to clinical severity (p-value 0.0001,0.0001&0.0001) and sex also influences clinical severity though statistically not significant (p-value 0.2).There was a significant relationship between positive X-Ray findings and decreased Spo2 level (p-value 0.0001, Cramer’s V 0.47).Regarding in-hospital outcome; 94.9% were recovered and 2.75%were death (only male)and following discharge; 42.60% (119) had post covid-19 complications and 0.72% (02) were dead. Comorbidities and age had an effect on short-term outcomes after hospital discharge though not statistically significant (p-value 0.16 and 0.16). The most common respiratory complications were SOB on exertion (23) and the most common non-respiratory complication was post covid fatigue syndrome (42). Comparison between Brixia score and post covid complications; more the Brixia score, the more the chance of post covid complications though statistically not significant (p-value 0.44). Conclusion: This study reveals bilateral lungs involvement and multifocal consolidations are the most common patterns of X-ray findings and clinical severity is associated with a higher Brixia score, male sex, increasing age, and presence of comorbidities. Bangladesh J Medicine 2022; 33: 280-292

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The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

Cited by 14 publications

References 113 publications

Comparison of Disease Severity and In-hospital Outcome of COVID-19 among Non-vaccinated versus Vaccinated (1st dose) Hospitalized Patients in a Tertiary Care Hospital: an Observational Study

Comparison of Disease Severity and In-hospital Outcome of COVID-19 among Non-vaccinated versus Vaccinated (1st dose) Hospitalized Patients in a Tertiary Care Hospital: an Observational Study

Clinical, Laboratory, and Imaging Findings of Pregnant Women with Possible Vertical Transmission of SARS-CoV-2—Case Series

Pattern of Chest X-rays findings and clinical correlation with the severity in COVID-19 (RT-PCR positive) infected patients admitted in a COVID-19 dedicated hospital in Bangladesh

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