Features of severe COVID-19: a systematic review and meta-analysis

Summary Introduction To systematically review clinical and biochemical characteristics associated with the severity of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19) Materials and methods Systematic review of observational studies from PubMed, ISI Web of Science, SCOPUS and Cochrane databases including people affected by COVID-19 and reporting data according to the severity of the disease Data were combined with odds ratio (OR) and metanalysed Severe COVID-19 was defined by acute respiratory distress syndrome, intensive care unit admission and death Results We included 12 studies with 2,794 patients, of whom 596 (21 33%) had severe disease A slightly higher age was found in severe versus non-severe disease We found that prevalent cerebrovascular disease (Odds Ratio [OR] 3 66, 95% Confidence Interval [CI] 1 73-7 72), chronic obstructive pulmonary disease (OR: 2 39, 95%CI 1 10-5 19), prevalent cardiovascular disease (OR: 2 84, 95%CI 1 59-5 10), diabetes (OR: 2 78, 95%CI 2 09-3 72), hypertension (OR: 2 24, 95%CI 1 63-3 08), smoking (OR: 1 54, 95%CI 1 07-2 22), and male sex (OR: 1 22, 95%CI 1 01-1 49) were associated with severe disease Furthermore, increased procalcitonin (OR: 8 21, 95%CI 4 48-15 07), increased D-Dimer (OR: 5 67, 95%CI 1 45-22 16) and thrombocytopenia (OR: 3 61, 95%CI 2 62-4 97) predicted severe infection Discussion Characteristics associated with the severity of SARS-CoV-2 infection may help to guide the early identification and management of patients with poor outcomes