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

https://doi.org/10.1016/j.ajic.2020.06.008Get rights and content
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open access

Highlights

  • Smoking was significantly associated with severe COVID-19 disease.

  • Patients with severe disease or ICU patients were more likely to have comorbidities.

  • Fever and dyspnea were significantly associated with severe COVID-19 disease.

  • Patients with severe disease had higher mortality rates and lower discharge rates.

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.

Key Words

COVID-19
Clinical characteristics
Prognosis
Severe illness
ICU cases

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Conflicts of interest: None to report.

Author contributions: J. L., X. H. and G.D. participated in study design; J. L. and X. H. performed data extraction and data analysis; J. L. and Y. Y. drafted the manuscript; All authors provided critical review of the manuscript and approved the final draft for publication.

Ethical approval: Approval was not required.