Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia

Am J Infect Control. 2021 Jan;49(1):82-89. doi: 10.1016/j.ajic.2020.06.008. Epub 2020 Jun 12.

Abstract

Objective: We aimed to investigate the relationship between clinical characteristics, outcomes and the severity of severe acute respiratory syndrome coronavirus 2 pneumonia.

Methods: We performed a systematic review and meta-analysis using PubMed, Embase, and Cochrane Library databases to assess the clinical characteristics and outcomes of confirmed COVID-19 cases and compared severe (ICU) and nonsevere (non-ICU) groups.

Results: We included 12 cohort studies including 2,445 patients with COVID-19. Compared with nonsevere (non-ICU) patients, severe (ICU) disease was associated with a smoking history (P = .003) and comorbidities including chronic obstructive pulmonary disease (OR = 5.08, P < .001), diabetes (OR = 3.17, P < .001), hypertension (OR = 2.40, P < .001), coronary heart disease (OR = 2.66, P < .001), cerebrovascular diseases (OR = 2.68, P = .008), and malignancy (OR=2.21, P = .040). We found significant differences between the 2 groups for fever, dyspnea, decreased lymphocyte and platelet counts, and increased leukocyte count, C-creative protein, procalcitonin, lactose dehydrogenase, aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and creatinine levels (P < .05). Significant differences were also observed for multiple treatments (P < .05). Patients in the severe (ICU) group were more likely to have complications and had a much higher mortality rate and lower discharge rate than those with nonsevere (non-ICU) disease (P < .05).

Conclusions: Investigation of clinical characteristics and outcomes of severe cases of COVID-19 will contribute to early prediction, accurate diagnosis, and treatment to improve the prognosis of patients with severe illness.

Keywords: COVID-19; Clinical characteristics; ICU cases; Prognosis; Severe illness.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • C-Reactive Protein / metabolism
  • COVID-19 / blood
  • COVID-19 / mortality
  • COVID-19 / physiopathology*
  • Cerebrovascular Disorders / epidemiology
  • Comorbidity
  • Coronary Disease / epidemiology
  • Creatine Kinase / blood
  • Creatinine / blood
  • Diabetes Mellitus / epidemiology
  • Dyspnea / physiopathology*
  • Fever / physiopathology*
  • Humans
  • Hypertension / epidemiology
  • Intensive Care Units
  • L-Lactate Dehydrogenase / blood
  • Leukocytosis / blood
  • Leukocytosis / physiopathology*
  • Lymphopenia / blood
  • Lymphopenia / physiopathology*
  • Procalcitonin / blood
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • SARS-CoV-2
  • Severity of Illness Index
  • Smoking / epidemiology
  • Thrombocytopenia / blood
  • Thrombocytopenia / physiopathology*

Substances

  • Procalcitonin
  • C-Reactive Protein
  • Creatinine
  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Creatine Kinase