Association of demographic, clinical, laboratory, and radiological characteristics with outcomes of COVID-19 patients: A systematic review and Meta-analysis

Authors : Partha Sarathi BİSWAS, Devosri SEN, Anirban HOMCHOUDHARY, Deepika MAKKAR, Mahima KAPOOR, Amandeep GOYAL

Pages : 121-135

Doi:10.5799/jmid.790260

View : 26 | Download : 4

Publication Date : 2020-09-15

Article Type : Research Paper

Abstract :Objectives: The aim of this meta-analysis was to assess association between a composite clinical outcome insert ignore into journalissuearticles values(severe infection/ required ICU admission/ death); of COVID-19 pneumonia and demographic, clinical, laboratory and radiological findings of these patients. Methods: A literature search was conducted using the databases PubMed, Medline, Scopus and Web of Science till July. Relative risk insert ignore into journalissuearticles values(RRs);, standardized mean difference insert ignore into journalissuearticles values(SMDs); and 95% confidence intervals insert ignore into journalissuearticles values(CIs); were pooled using random-effects models. We described overall estimates of relevant data of clinical importance from 116,260 COVID-19 pneumonia patients including 19,628 with composite end points from 40 observational studies of 5 countries. Results: The result showed that male gender insert ignore into journalissuearticles values(RR=1.24, p 64 years insert ignore into journalissuearticles values(RR=2.52, P <.001); followed aggravated course. Delayed hospitalization insert ignore into journalissuearticles values(SMD=.75, p= 0.005);, presence of co-morbidity insert ignore into journalissuearticles values(RR= 1.76, p<.001); and multiple co-morbidities insert ignore into journalissuearticles values(RR=1.50, p<.001); were associated with higher risk of fatal course. Pooled data reported significantly high neutrophil-lymphocyte ratio insert ignore into journalissuearticles values(SMD=10.79, p<.001);, low lymphocyte-to-C-reactive protein ratio insert ignore into journalissuearticles values(SMD=-3.89, p<.001);, low platelet count insert ignore into journalissuearticles values(SMD=-1.622, p<.001);, prolonged prothrombin time insert ignore into journalissuearticles values(SMD=0.98, p<.001);, high lactate dehydrogenase insert ignore into journalissuearticles values(SMD=6.260, p<.001);, D-dimer insert ignore into journalissuearticles values(SMD=1.92, p<.001);, creatine kinase insert ignore into journalissuearticles values(SMD=1.68, p= 0.001); and interleukin-6 level insert ignore into journalissuearticles values(SMD=2.84, P=.001); in patients with fatal outcome. Funnel plots and Egger’s tests did not reveal any significant publication bias. Conclusions: Features like older age, male gender, presence of co-morbidities and delayed hospitalization along with the laboratory findings consistent with infection, immune system activation, coagulation disorder and tissue damage could help clinicians to identify COVID-19 patients with poor prognosis at an early stage. J Microbiol Infect Dis 2019; 9insert ignore into journalissuearticles values(3);:121-135.
Keywords : COVID 19, risk factors, predictors, statistical association, outcome, adversity, death fatality, laboratory results

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