文献类型：期刊文献

英文题名：Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis

作者：Zheng, Zhaohai[1,2];Peng, Fang[1];Xu, Buyun[1];Zhao, Jingjing[1,2];Liu, Huahua[3];Peng, Jiahao[4];Li, Qingsong[5];Jiang, Chongfu[5];Zhou, Yan[1];Liu, Shuqing[1,6];Ye, Chunji[1];Zhang, Peng[1];Xing, Yangbo[1];Guo, Hangyuan[1];Tang, Weiliang[1]

机构：[1]Zhejiang Univ Sch Med, Shaoxing Peoples Hosp, Dept Cardiol, Shaoxing Hosp, Shaoxing City 312000, Zhejiang, Peoples R China;[2]Zhejiang Univ, Run Run Shaw Affiliated Hosp, Sch Med, Dept Cardiol, Hangzhou 310003, Zhejiang, Peoples R China;[3]Xi An Jiao Tong Univ, Cardiovasc Res Ctr, Sch Basic Med Sci, Hlth Sci Ctr, Xian 710049, Peoples R China;[4]Loma Linda Univ, Sch Publ Hlth, 24951 Circle Dr, Loma Linda, CA 92354 USA;[5]Awati Cty Peoples Hosp, Dept Cardiol, 1 North Jiefang Rd, Xinjiang Uygur Autonomou 843000, Peoples R China;[6]Shaoxing Univ, Sch Med, Shaoxing 312000, Zhejiang, Peoples R China

年份：2020

卷号：81

期号：2

起止页码：E16

外文期刊名：JOURNAL OF INFECTION

收录：SCI-EXPANDED(收录号：WOS:000553365200004)、、Scopus(收录号：2-s2.0-85083878865)、WOS

语种：英文

外文关键词：COVID-19; Risk factor; Comorbidity; Clinical manifestation; Laboratory examination

外文摘要：Background: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help. Methods: The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis. Results: Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR= 1.76, 95% CI (1.41, 2.18), P < 0.00001; age over 65 years old: OR =6.06, 95% CI(3.98, 9.22), P < 0.00001; current smoking: OR =2.51, 95% CI(1.39, 3.32), P =0.0006). The proportion of underlying diseases such as hypertension, diabetes, cardiovascular disease, and respiratory disease were statistically significant higher in critical/mortal patients compared to the non-critical patients (diabetes: OR=3.68, 95% CI (2.68, 5.03), P < 0.00001; hypertension: OR= 2.72, 95% CI (1.60,4.64), P=0.0002; cardiovascular disease: OR =5.19, 95% CI(3.25, 8.29), P < 0.00001; respiratory disease: OR 5.15, 95% CI(2.51, 10.57), P < 0.00001). Clinical manifestations such as fever, shortness of breath or dyspnea were associated with the progression of disease [fever: OR =0.56, 95% CI (0.38, 0.82), P =0.003;shortness of breath or dyspnea: OR=4.16, 95% CI (3.13, 5.53), P < 0.00001]. Laboratory examination such as aspartate amino transferase(AST) > 40U/L, creatinine(Cr) >= 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC)<4 x 10(9)/L meant a better clinical status[AST > 40U/L:OR=4.00, 95% CI (2.46, 6.52), P < 0.00001; Cr > 133 mu mol/L: OR= 5.30, 95% CI (2.19, 12.83), P=0.0002; hs-cTnI > 28 pg/mL: OR= 43.24, 95% CI (9.92, 188.49), P < 0.00001; PCT > 0.5 ng/mL: OR =43.24, 95% CI (9.92, 188.49), P < 0.00001;LDH > 245U/L: OR= 43.24, 95% CI (9.92, 188.49), P < 0.00001; D-dimer > 0.5mg/L: OR= 43.24, 95% CI (9.92, 188.49), P < 0.00001; WBC < 4 x 10(9)/L: OR= 0.30, 95% CI (0.17, 0.51), P < 0.00001]. Conclusion: Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19. (C) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.