Predictors of mortality in hospitalized COVID‐19 patients: A systematic review and meta‐analysis. Issue 10 (11th July 2020)

• Record Type: Journal Article
• Authors: Tian, Wenjie; Jiang, Wanlin; Yao, Jie; Nicholson, Christopher J.; Li, Rebecca H.; Sigurslid, Haakon H.; Wooster, Luke; Rotter, Jerome I.; Guo, Xiuqing; Malhotra, Rajeev
• Other Names: Luo Guangxiang (George) guestEditor.; Ly Hinh guestEditor.; Gao Shou‐Jiang guestEditor.
• Is Part Of: Journal of medical virology. Volume 92:Issue 10(2020)
• Page Start: 1875
• Page End: 1883
• Publication Date: 2020-07-11
• Subjects: cardiovascular disease -- COVID‐19 -- diabetes -- meta‐analysis; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.26050
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract: Mortality rates of coronavirus disease‐2019 (COVID‐19) continue to rise across the world. Information regarding the predictors of mortality in patients with COVID‐19 remains scarce. Herein, we performed a systematic review of published articles, from 1 January to 24 April 2020, to evaluate the risk factors associated with mortality in COVID‐19. Two investigators independently searched the articles and collected the data, in accordance with PRISMA guidelines. We looked for associations between mortality and patient characteristics, comorbidities, and laboratory abnormalities. A total of 14 studies documenting the outcomes of 4659 patients were included. The presence of comorbidities such as hypertension (odds ratio [OR], 2.5; 95% confidence interval [CI], 2.1‐3.1; P < .00001), coronary heart disease (OR, 3.8; 95% CI, 2.1‐6.9; P < .00001), and diabetes (OR, 2.0; 95% CI, 1.7‐2.3; P < .00001) were associated with significantly higher risk of death amongst patients with COVID‐19. Those who died, compared with those who survived, differed on multiple biomarkers on admission including elevated levels of cardiac troponin (+44.2 ng/L, 95% CI, 19.0‐69.4; P = .0006); C‐reactive protein (+66.3 µg/mL, 95% CI, 46.7‐85.9; P < .00001); interleukin‐6 (+4.6 ng/mL, 95% CI, 3.6‐5.6; P < .00001); D‐dimer (+4.6 µg/mL, 95% CI, 2.8‐6.4; P < .00001); creatinine (+15.3 µmol/L, 95% CI, 6.2‐24.3; P = .001); and alanine transaminase (+5.7 U/L, 95% CI, 2.6‐8.8; P = .0003); as well as decreased levels of albumin (−3.7 g/L, 95% CI, −5.3 to −2.1; P < .00001). Individuals with underlying cardiometabolic disease and that present with evidence for acute inflammation and end‐organ damage are at higher risk of mortality due to COVID‐19 infection and should be managed with greater intensity. Highlights: This systematic review and meta‐analysis of 14 studies including a total of 4659 patients comprehensively identifies the risk factors associated with mortality in COVID‐19 included clinical comorbidities such as hypertension, coronary heart disease, and diabetes, as well as laboratory abnormalities including elevated levels of cardiac troponin, interleukin‐6, C‐reactive protein, D‐dimer and markers of liver and renal function.