scholarly journals Association of age, sex, comorbidities, and clinical symptoms with the severity and mortality of COVID-19 cases: a meta-analysis with 85 studies and 67299 cases

Author(s):  
Mohammad Safiqul Islam ◽  
Md. Abdul Barek ◽  
Md. Abdul Aziz ◽  
Tutun Das Aka ◽  
Md. Jakaria

AbstractBackgroundA new pathogenic disease named COVID-19 became a global threat, first reported in Wuhan, China, in December 2019. The number of affected cases growing exponentially and now, more than 210 countries confirmed the cases.ObjectiveThis meta-analysis aims to evaluate risk factors, the prevalence of comorbidity, and clinical characteristics in COVID-19 death patients compared to survival patients that can be used as a reference for further research and clinical decisions.MethodsPubMed, Science Direct, SAGE were searched to collect data about demographic, clinical characteristics, and comorbidities of confirmed COVID-19 patients from January 1, 2020, to May 17, 2020. Meta-analysis was performed with the use of Review Manager 5.3ResultsEighty-five studies were included in Meta-analysis, including a total number of 67,299 patients with SARS-CoV-2 infection. Males are severely affected or died than females (OR = 2.26, p < 0.00001; OR = 3.59, p < 0.00001) are severely affected, or died by COVID-19 and cases with age ≥50 are at higher risk of death than age <50 years (OR=334.23). Presence of any comorbidity or comorbidities like hypertension, cardiovascular disease, diabetes, cerebrovascular disease, respiratory disease, kidney disease, liver disease, malignancy significantly increased the risk of death compared to survival (OR = 3.46, 3.16, 4.67, 2.45, 5.84, 2.68, 5.62, 2.81,2.16). Among the clinical characteristics such as fever, cough, myalgia, diarrhea, abdominal pain, dyspnea, fatigue, sputum production, chest tightness headache and nausea or vomiting, only fatigue (OR = 1.31, 95%) and dyspnea increased the death significantly (OR= 1.31, 4.57). The rate of death of COVID-19 cases is 0.03-times lower than the rate of survival (OR = 0.03).ConclusionOur result indicates that male patients are affected severely or died, the rate of death is more in the age ≥50 group, and the rate of death is affected by comorbidities and clinical symptoms.

Author(s):  
BIKASH BISWAS ◽  
INDRANI PRAMANIK ◽  
SANJUKTA MANDAL ◽  
POULAMY SINGHA ROY

Objectives: According to the recent studies, it is seen that coronavirus disease 2019 (COVID-19) infection is associated with many bacterial and fungal infections. In case of COVID-19 patients, diabetes mellitus (DM) and hypertension (HTN) are the prime risk factors and during the course of treatment, patients develop secondary fungal infections like mucormycosis. We conducted a systemic review of the present scenario and tried to evaluate the association of mucormycosis with COVID-19. Methods: We searched articles related to the COVID-19 associated mucormycosis, in PubMed, IndMed, and Cochrane Library. We conducted a meta-analysis on the basis of systemically reviewed all articles which reported COVID-19 associated with mucormycosis. We analyzed comorbidity, treatment, and outcome of patients in association with COVID-19 and mucormycosis. Results: We found a total of 196 articles based on mucormycosis, out of which only 25 were selected on the basis of our inclusion and exclusion criteria. 71 cases were found and most of the cases were from India and USA. We also found that it was more prevalent among male patients and patients with DM, and in association with HTN. Conclusion: It is seen from the studies that patients already suffering from DM and HTN when infected with coronavirus are most likely to develop mucormycosis. Treatment of latent DM, prediabetic patients, conversely, that efforts to diagnose, detect, and treat DM may have a beneficial influence in the treatment of secondary fungal infections like mucormycosis. Finding out all the cases of DM and treatment of DM can carry out an advantageous effect in all patients suffering from COVID-19.


2020 ◽  
Author(s):  
Sergio Alejandro Gómez-Ochoa ◽  
Oscar H. Franco ◽  
Lyda Z. Rojas ◽  
Sandra Lucrecia Romero Guevara ◽  
Luis Eduardo Echeverría ◽  
...  

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ghodsiyeh Azarkar ◽  
Freshteh Osmani

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.


Author(s):  
Francesc X. Marin-Gomez ◽  
Jacobo Mendioroz-Peña ◽  
Miguel-Angel Mayer ◽  
Leonardo Méndez-Boo ◽  
Núria Mora ◽  
...  

Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two population groups. Our results showed that the form of presentation of the epidemic outbreak, as well as some risk factors, are different among the elderly institutionalised population with respect to those who are not. In addition to a twenty-fold increase in the rate of adjusted mortality among institutionalised individuals, the peak incidence was delayed by approximately three weeks. Having dementia was shown to be a risk factor for death, and, unlike the non-institutionalised group, neither obesity nor age were shown to be significantly associated with the risk of death among the institutionalised. These differential characteristics should be able to guide the actions to be taken by the health administration in the event of a similar infectious situation among institutionalised elderly people.


Author(s):  
Chaoqun Ma ◽  
Jiawei Gu ◽  
Pan Hou ◽  
Liang Zhang ◽  
Yuan Bai ◽  
...  

AbstractBackgroundRecently, Coronavirus Disease 2019 (COVID-19) outbreak started in Wuhan, China. Although the clinical features of COVID-19 have been reported previously, data regarding the risk factors associated with the clinical outcomes are lacking.ObjectivesTo summary and analyze the clinical characteristics and identify the predictors of disease severity and mortality.MethodsThe PubMed, Web of Science Core Collection, Embase, Cochrane and MedRxiv databases were searched through February 25, 2020. Meta-analysis of Observational Studies in Epidemiology (MOOSE) recommendations were followed. We extracted and pooled data using random-e□ects meta-analysis to summary the clinical feature of the confirmed COVID-19 patients, and further identify risk factors for disease severity and death. Heterogeneity was evaluated using the I2 method and explained with subgroup analysis and meta-regression.ResultsA total of 30 studies including 53000 patients with COVID-19 were included in this study, the mean age was 49.8 years (95% CI, 47.5-52.2 yrs) and 55.5% were male. The pooled incidence of severity and mortality were 20.2% (95% CI, 15.1-25.2%) and 3.1% (95% CI, 1.9-4.2%), respectively. The predictor for disease severity included old age (≥ 50 yrs, odds ratio [OR] = 2.61; 95% CI, 2.29-2.98), male (OR =1.348, 95% CI, 1.195-1.521), smoking (OR =1.734, 95% CI, 1.146-2.626) and any comorbidity (OR = 2.635, 95% CI, 2.098-3.309), especially chronic kidney disease (CKD, OR = 6.017; 95% CI, 2.192-16.514), chronic obstructive pulmonary disease (COPD, OR = 5.323; 95% CI, 2.613-10.847) and cerebrovascular disease (OR = 3.219; 95% CI, 1.486-6.972). In terms of laboratory results, increased lactate dehydrogenase (LDH), C-reactive protein (CRP) and D-dimer and decreased blood platelet and lymphocytes count were highly associated with severe COVID-19 (all for P < 0.001). Meanwhile, old age (≥ 60 yrs, RR = 9.45; 95% CI, 8.09-11.04), followed by cardiovascular disease (RR = 6.75; 95% CI, 5.40-8.43) hypertension (RR = 4.48; 95% CI, 3.69-5.45) and diabetes (RR = 4.43; 95% CI, 3.49-5.61) were found to be independent prognostic factors for the COVID-19 related death.ConclusionsTo our knowledge, this is the first evidence-based medicine research to explore the risk factors of prognosis in patients with COVID-19, which is helpful to identify early-stage patients with poor prognosis and adapt effective treatment.


Author(s):  
Jing Chen ◽  
Hualin Bai ◽  
Jia Liu ◽  
Ge Chen ◽  
Qiuyue Liao ◽  
...  

Abstract Background As the coronavirus disease 2019 (COVID-19) outbreak accelerates worldwide, it is important to evaluate sex-specific clinical characteristics and outcomes, which may affect public health policies. Methods Patients with COVID-19 admitted to Tongji Hospital between 18 January and 27 March 2020 were evaluated. Clinical features, laboratory data, complications, and outcomes were compared between females and males. Risk factors for mortality in the whole population, females, and males were determined respectively. Results There were 1667 (50.38%) females among the 3309 patients. The mortality rate was 5.9% in females but 12.7% in males. Compared with males, more females had no initial symptoms (11.1% vs 8.3%, P = .008). Complications including acute respiratory distress syndrome, acute kidney injury, septic shock, cardiac injury, and coagulation disorder were less common in females; critical illness was also significantly less common in females (31.1% vs 39.4%, P &lt; .0001). Significantly fewer females received antibiotic treatment (P = .001), antiviral therapy (P = .025), glucocorticoids treatment (P &lt; .0001), mechanical ventilation (P &lt; .0001), and had intensive care unit admission (P &lt; .0001). A lower risk of death was found in females (OR, .44; 95% CI, .34–.58) after adjusting for age and coexisting diseases. Among females, age, malignancy, chronic kidney disease, and days from onset to admission were significantly associated with mortality, while chronic kidney disease was not a risk factor in males. Conclusions Significantly milder illness and fewer deaths were found in female COVID-19 inpatients and risk factors associated with mortality varied among males and females.


2020 ◽  
Author(s):  
Zhufeng Wang ◽  
Hongsheng Deng ◽  
Changxing Ou ◽  
Jingyi Liang ◽  
Yingzhi Wang ◽  
...  

Abstract Background: The pandemic of COVID-19 posed a challenge to global healthcare. The mortality rates of severe cases range from 8.1% to 31.8%, and it is particularly important to identify risk factors that aggravate the disease.Methods: We performed a systematic review of the literature with meta-analysis, using 7 databases to assess clinical characteristics, comorbidities and complications in severe and non-severe patients with COVID-19. All the observational studies were included. We performed a random or fixed effects model meta-analysis to calculate the pooled proportion and 95% CI. Measure of heterogeneity was estimated by Cochran’s Q statistic, I2 index and P value.Results: 4881 cases from 25 studies related to COVID-19 were included. The most prevalent comorbidity was hypertension (severe: 33.4%, 95% CI: 25.4% - 41.4%; non-severe 21.6%, 95% CI: 9.9% - 33.3%), followed by diabetes (severe: 14.4%, 95% CI: 11.5% - 17.3%; non-severe: 8.5%, 95% CI: 6.1% - 11.0%). The prevalence of ARDS, AKI and shock were all higher in severe cases, with 41.1% (95% CI: 14.1% - 68.2%), 16.4% (95% CI: 3.4% - 29.5%) and 19.9% (95% CI: 5.5% - 34.4%), rather than 3.0% (95% CI: 0.6% - 5.5%), 2.2% (95% CI: 0.1% - 4.2%) and 4.1% (95% CI -4.8% - 13.1%) in non-severe patients, respectively. The death rate was higher in severe cases (30.3%, 95% CI: 13.8% - 46.8%) than non-severe cases (1.5%, 95% CI: 0.1% - 2.8%).Conclusions: Hypertension, diabetes and cardiovascular diseases may be risk factors for COVID-19 patients to develop into severe cases.


2020 ◽  
Author(s):  
Sylvain Mathieu ◽  
Bruno Pereira ◽  
Frederic Dutheil ◽  
Martin Soubrier

Abstract Background. Patients with Dupuytren’s disease (DD) may have a higher cardiovascular (CV) risk because of association with diseases with a higher recognized CV risk, such as diabetes. However, DD is not always linked to these diseases; therefore, it seems relevant to assess the CV profile in DD.Methods. We performed a systematic literature review up to April 2020. Differences between DD patients and controls were expressed as standardized mean differences using the inverse-variance method or as odds ratios (ORs) using the Mantel-Haenszel method. Results. We obtained 51 references corresponding to 112,900 DD patients and 2,383,177 controls. We found a higher risk of death (OR=1.72 [95%CI:1.37-2.16]) and CV death (118/974 DD patients vs. 372/3948 controls; OR=1.33 [95%CI:1.07-1.66]) among DD patients compared to controls. DD patients were more often diabetic (OR=3.44 [95% CI:2.69-4.38]). In 17 studies of the general population, the incidence of diabetes was 17.5% among DD patients (11.7-24.2%). DD patients were older, and more often men or alcohol drinkers. The percentage of smokers and levels of blood pressure or total cholesterol were not different among DD patients and controls. No difference was found in triglycerides, but the risk of obesity was significantly lower in DD patients.Conclusions. We found a higher CV risk in DD but not a higher prevalence of CV risk factors, except diabetes. This may be due to the predominance of men or greater number of alcohol drinkers or diabetics. Management of CV risk is important in patients with DD, including research on alcohol consumption or diabetes.


Author(s):  
Lizhen Xu ◽  
Yaqian Mao ◽  
Gang Chen

AbstractImportanceWith 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.ObjectiveTo systematically review the evidence of risk factors for severe corona virus disease 2019 (COVID-19) patients.Evidence ReviewWe conducted a comprehensive search for primary literature in 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.Results20 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.InterpretationThis is the first systematic review investigating the risk factors for severe corona virus disease 2019 (COVID-19) patients. The findings are presented and discussed by different clinical characteristics. Therefore, our review may provide guidance for clinical decision-making and optimizes resource allocation.Key PointsQuestionWhat are the risk factors for severe patients with corona virus disease 2019 (COVID-19)?FindingsFirst 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.MeaningThis review summaried the risk factors of severe COVID-19 patients and aim to provide a basis for early identification of severe patients by clinicians.


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