Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients.
Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients.
复制标题
DOI：
10.1371/journal.pone.0243191
复制
发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Dolma R
中科院分区：
文献类型：
--
作者：
Dorjee K;Kim H;Bonomo E;Dolma R
对COVID-19发展为严重疾病和死亡的认识不足。总结风险因素和不良结局的患病率，并确定其与住院的COVID-19患者的相关性。我们在Medline、Embase和Web of Science中检索了截至2020年8月31日的住院COVID-19患者的病例系列和观察性研究。通过固定效应荟萃分析，使用海岸调整的置信区间对数据进行分析，以解决异质性问题。77项研究（包括38906例住院患者）符合入选标准; 21468项来自美国-欧洲，9740项来自中国。COVID-19的总体死亡率[%（95%CI）]为20%（18-23%）;美国和欧洲为23%（19-27%），中国为11%（7-16%）。在死亡的患者中，85%的患者年龄≥60岁，66%为男性，66%、44%、39%、37%和27%分别患有高血压、吸烟史、糖尿病、心脏病和慢性肾病（CKD）。心脏病、COPD、慢性肾病（CKD）、慢性肝病（CLD）、高血压和糖尿病的病死率风险[%（95% CI）]分别为52%（46-60）、51%（43-59）、48%（37-63）、39%（CLD）、28%（23-36%）和24%（17-33%）。年龄≥60岁[sRR = 3.6; 95% CI：3.0-4.4]、男性[1.3; 1.2-1.4]、吸烟史[1.3; 1.1-1.6]、COPD [1.7; 1.4-2.0]、高血压[1.8; 1.6-2.0]、糖尿病[1.5; 1.4-1.7]、心脏病[2.1; 1.8-2.4]、CKD [2.5; 2.1-3.0]。美国COVID-19住院患者的高血压（55%）、糖尿病（33%）、吸烟史（23%）和心脏病（17%）患病率显著高于美国普通人群，表明患有合并症的个体对感染或疾病进展的易感性增加。COVID-19的公共卫生筛查可根据风险群体进行优先排序。适当解决吸烟、高血压和糖尿病等可改变的风险因素可以降低COVID-19的发病率和死亡率;公共信息可以相应调整。
Progression of COVID-19 to severe disease and death is insufficiently understood. Summarize the prevalence of risk factors and adverse outcomes and determine their associations in COVID-19 patients who were hospitalized. We searched Medline, Embase and Web of Science for case-series and observational studies of hospitalized COVID-19 patients through August 31, 2020. Data were analyzed by fixed-effects meta-analysis using Shore’s adjusted confidence intervals to address heterogeneity. Seventy-seven studies comprising 38906 hospitalized patients met inclusion criteria; 21468 from the US-Europe and 9740 from China. Overall prevalence of death [% (95% CI)] from COVID-19 was 20% (18–23%); 23% (19–27%) in the US and Europe and 11% (7–16%) for China. Of those that died, 85% were aged≥60 years, 66% were males, and 66%, 44%, 39%, 37%, and 27% had hypertension, smoking history, diabetes, heart disease, and chronic kidney disease (CKD), respectively. The case fatality risk [%(95% CI)] were 52% (46–60) for heart disease, 51% (43–59) for COPD, 48% (37–63) for chronic kidney disease (CKD), 39% for chronic liver disease (CLD), 28% (23–36%) for hypertension, and 24% (17–33%) for diabetes. Summary relative risk (sRR) of death were higher for age≥60 years [sRR = 3.6; 95% CI: 3.0–4.4], males [1.3; 1.2–1.4], smoking history [1.3; 1.1–1.6], COPD [1.7; 1.4–2.0], hypertension [1.8; 1.6–2.0], diabetes [1.5; 1.4–1.7], heart disease [2.1; 1.8–2.4], CKD [2.5; 2.1–3.0]. The prevalence of hypertension (55%), diabetes (33%), smoking history (23%) and heart disease (17%) among the COVID-19 hospitalized patients in the US were substantially higher than that of the general US population, suggesting increased susceptibility to infection or disease progression for the individuals with comorbidities. Public health screening for COVID-19 can be prioritized based on risk-groups. Appropriately addressing the modifiable risk factors such as smoking, hypertension, and diabetes could reduce morbidity and mortality due to COVID-19; public messaging can be accordingly adapted.
登录
查看更多内容
影响因子：
3.1
作者：
Chilimuri, Sridhar;Sun, Haozhe;Nayudu, Suresh K.
通讯作者：
Nayudu, Suresh K.
影响因子：
2.9
作者：
Claudia, Gregoriano;Daniel, Koch;Philipp, Schuetz
通讯作者：
Philipp, Schuetz
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
15.9
作者：
Chen, Guang;Wu, Di;Ning, Qin
通讯作者：
Ning, Qin
影响因子：
28.2
作者：
Chen, Jun;Qi, Tangkai;Lu, Hongzhou
通讯作者：
Lu, Hongzhou