Τίτλος:
Predictors of adverse prognosis in COVID-19: A systematic review and meta-analysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Identification of reliable outcome predictors in coronavirus disease 2019 (COVID-19) is of paramount importance for improving patient's management. Methods: A systematic review of literature was conducted until 24 April 2020. From 6843 articles, 49 studies were selected for a pooled assessment; cumulative statistics for age and sex were retrieved in 587 790 and 602 234 cases. Two endpoints were defined: (a) a composite outcome including death, severe presentation, hospitalization in the intensive care unit (ICU) and/or mechanical ventilation; and (b) in-hospital mortality. We extracted numeric data on patients’ characteristics and cases with adverse outcomes and employed inverse variance random-effects models to derive pooled estimates. Results: We identified 18 and 12 factors associated with the composite endpoint and death, respectively. Among those, a history of CVD (odds ratio (OR) = 3.15, 95% confidence intervals (CIs) 2.26-4.41), acute cardiac (OR = 10.58, 5.00-22.40) or kidney (OR = 5.13, 1.78-14.83) injury, increased procalcitonin (OR = 4.8, 2.034-11.31) or D-dimer (OR = 3.7, 1.74-7.89), and thrombocytopenia (OR = 6.23, 1.031-37.67) conveyed the highest odds for the adverse composite endpoint. Advanced age, male sex, cardiovascular comorbidities, acute cardiac or kidney injury, lymphocytopenia and D-dimer conferred an increased risk of in-hospital death. With respect to the treatment of the acute phase, therapy with steroids was associated with the adverse composite endpoint (OR = 3.61, 95% CI 1.934-6.73), but not with mortality. Conclusions: Advanced age, comorbidities, abnormal inflammatory and organ injury circulating biomarkers captured patients with an adverse clinical outcome. Clinical history and laboratory profile may then help identify patients with a higher risk of in-hospital mortality. © 2020 Stichting European Society for Clinical Investigation Journal Foundation
Συγγραφείς:
Figliozzi, S.
Masci, P.G.
Ahmadi, N.
Tondi, L.
Koutli, E.
Aimo, A.
Stamatelopoulos, K.
Dimopoulos, M.-A.
Caforio, A.L.P.
Georgiopoulos, G.
Περιοδικό:
European Journal of Clinical Investigation
Εκδότης:
Wiley-Blackwell Publishing Ltd
Λέξεις-κλειδιά:
biological marker; D dimer; procalcitonin; steroid; C reactive protein; corticosteroid; ferritin; fibrin degradation product; fibrin fragment D; interleukin 6; procalcitonin, acute kidney failure; adverse outcome; age; Article; artificial ventilation; cardiovascular disease; comorbidity; coronavirus disease 2019; heart injury; hospital mortality; hospitalization; human; intensive care unit; lymphocytopenia; medical history; meta analysis; organ injury; priority journal; prognosis; protein blood level; steroid therapy; systematic review; thrombocytopenia; acute disease; acute kidney failure; adult; aged; Betacoronavirus; cardiovascular disease; cerebrovascular disease; chronic obstructive lung disease; Coronavirus infection; diabetes mellitus; female; heart disease; hypertension; liver disease; lymphocytopenia; male; metabolism; middle aged; mortality; neoplasm; obesity; pandemic; prognosis; severity of illness index; sex factor; smoking; thrombocytopenia; very elderly; virus pneumonia; young adult, Acute Disease; Acute Kidney Injury; Adrenal Cortex Hormones; Adult; Age Factors; Aged; Aged, 80 and over; Betacoronavirus; C-Reactive Protein; Cardiovascular Diseases; Cerebrovascular Disorders; Coronavirus Infections; Diabetes Mellitus; Female; Ferritins; Fibrin Fibrinogen Degradation Products; Heart Diseases; Hospital Mortality; Hospitalization; Humans; Hypertension; Intensive Care Units; Interleukin-6; Liver Diseases; Lymphopenia; Male; Middle Aged; Neoplasms; Obesity; Pandemics; Pneumonia, Viral; Procalcitonin; Prognosis; Pulmonary Disease, Chronic Obstructive; Respiration, Artificial; Severity of Illness Index; Sex Factors; Smoking; Thrombocytopenia; Young Adult
