Clinical determinants of severe COVID-19 disease – A systematic review and meta-analysis

Background: A systematic review and meta-analysis of available studies was performed to investigate the clinical characteristics that can predict COVID-19 disease severity Materials and Methods: Databases including PubMed, Embase, and Web of Science were searched from December 31, 2019, to May 24, 2020 Random-effects meta-analysis was used for summarizing the Pooled odds ratio (pOR) of individual clinical characteristics to describe their association with severe COVID-19 disease Results: A total of 3895 articles were identified, and finally, 22 studies comprising 4380 patients were included Severe disease was more common in males than females (pOR: 1 36, 95% confidence interval [CI]: 1 08-1 70) Clinical features that were associated with significantly higher odds of severe disease were abdominal pain (pOR: 6 58, 95% CI: 1 56-27 67), breathlessness (pOR: 3 94, 95% CI: 2 55-6 07), and hemoptysis (pOR: 3 35, 95% CI: 1 05-10 74) pOR was highest for chronic obstructive pulmonary disease (pOR: 2 92, 95% CI: 1 70-5 02), followed by obesity (pOR: 2 84, 95% CI: 1 19-6 77), malignancy (pOR: 2 38, 95% CI: 1 25-4 52), diabetes (pOR: 2 29, 95% CI: 1 56-3 39), hypertension (pOR: 1 72, 95% CI: 1 23-2 42), cardiovascular disease (pOR: 1 61, 95% CI: 1 31-1 98) and chronic kidney disease (pOR: 1 46, 95% CI: 1 06-2 02), for predicting severe COVID-19 Conclusion: Our analysis describes the association of specific symptoms and comorbidities with severe COVID-19 disease Knowledge of these clinical determinants will assist the clinicians in the risk-stratification of these patients for better triage and clinical management © 2021 Wolters Kluwer Medknow Publications All rights reserved