Predictors of COVID-19 severity: a systematic review and meta-analysis.
Predictors of COVID-19 severity: a systematic review and meta-analysis.
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DOI：
10.12688/f1000research.26186.1
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发表时间：
2020-01-01
期刊：
影响因子：
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通讯作者：
Harapan, Harapan
中科院分区：
文献类型：
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作者：
Mudatsir, Mudatsir;Fajar, Jonny Karunia;Harapan, Harapan
背景：2019冠状病毒病（COVID-19）进展的不可预测性可能归因于用于预测该疾病预后的工具精度较低。目的：探讨与COVID-19患者临床预后不良相关的预测因素。方法：检索并提取截至2020年4月5日的PubMed、Embase、Cochrane和Web of Science的相关文章。收集感兴趣的数据并评估其与meta分析的兼容性。使用Z检验进行累积计算以确定相关性和效应估计。结果：共收录论文19篇，轻症1934例，重症1644例。在初步评估的基础上，确定了62个潜在的危险因素进行meta分析。慢性呼吸系统疾病、心血管疾病、糖尿病、高血压等合并症在重症患者中的发生率高于轻症患者。与轻度形式相比，严重的COVID-19与呼吸困难、厌食、疲劳、呼吸频率增加和收缩压高等症状相关。淋巴细胞和血红蛋白水平降低；白细胞、天冬氨酸转氨酶、丙氨酸转氨酶、血肌酐、血尿素氮、高敏肌钙蛋白、肌酸激酶、高敏c反应蛋白、白细胞介素6、d -二聚体、铁蛋白、乳酸脱氢酶和降钙素原水平升高；高红细胞沉降率也与严重的COVID-19有关。结论：30多种危险因素与重症COVID-19的高风险相关。这些可作为开发COVID-19预后预测工具的有用基线参数。
Background: The unpredictability of the progression of coronavirus disease 2019 (COVID-19) may be attributed to the low precision of the tools used to predict the prognosis of this disease. Objective: To identify the predictors associated with poor clinical outcomes in patients with COVID-19. Methods: Relevant articles from PubMed, Embase, Cochrane, and Web of Science were searched and extracted as of April 5, 2020. Data of interest were collected and evaluated for their compatibility for the meta-analysis. Cumulative calculations to determine the correlation and effect estimates were performed using the Z test. Results: In total, 19 papers recording 1,934 mild and 1,644 severe cases of COVID-19 were included. Based on the initial evaluation, 62 potential risk factors were identified for the meta-analysis. Several comorbidities, including chronic respiratory disease, cardiovascular disease, diabetes mellitus, and hypertension were observed more frequent among patients with severe COVID-19 than with the mild ones. Compared to the mild form, severe COVID-19 was associated with symptoms such as dyspnea, anorexia, fatigue, increased respiratory rate, and high systolic blood pressure. Lower levels of lymphocytes and hemoglobin; elevated levels of leukocytes, aspartate aminotransferase, alanine aminotransferase, blood creatinine, blood urea nitrogen, high-sensitivity troponin, creatine kinase, high-sensitivity C-reactive protein, interleukin 6, D-dimer, ferritin, lactate dehydrogenase, and procalcitonin; and a high erythrocyte sedimentation rate were also associated with severe COVID-19. Conclusion: More than 30 risk factors are associated with a higher risk of severe COVID-19. These may serve as useful baseline parameters in the development of prediction tools for COVID-19 prognosis.