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Features of severe COVID-19: A systematic review and meta-analysis.
Eur J Clin Invest. 2020 Oct; 50(10):e13378.EJ

Abstract

BACKGROUND

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 2794 patients, of whom 596 (21.33%) had severe disease. A slightly higher age was found in severe vs 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.

CONCLUSION

Characteristics associated with the severity of SARS-CoV-2 infection may allow an early identification and management of patients with poor outcomes.

Authors+Show Affiliations

I Clinica Medica, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.Department of Economics and Finance, University of Rome "Tor Vergata", Rome, Italy.I Clinica Medica, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. Mediterranea Cardiocentro, Naples, Italy.I Clinica Medica, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Rome, Italy. Emergency Department, Policlinico Tor Vergata Hospital, Rome, Italy.I Clinica Medica, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy. Mediterranea Cardiocentro, Naples, Italy.I Clinica Medica, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32860457

Citation

Del Sole, Francesco, et al. "Features of Severe COVID-19: a Systematic Review and Meta-analysis." European Journal of Clinical Investigation, vol. 50, no. 10, 2020, pp. e13378.
Del Sole F, Farcomeni A, Loffredo L, et al. Features of severe COVID-19: A systematic review and meta-analysis. Eur J Clin Invest. 2020;50(10):e13378.
Del Sole, F., Farcomeni, A., Loffredo, L., Carnevale, R., Menichelli, D., Vicario, T., Pignatelli, P., & Pastori, D. (2020). Features of severe COVID-19: A systematic review and meta-analysis. European Journal of Clinical Investigation, 50(10), e13378. https://doi.org/10.1111/eci.13378
Del Sole F, et al. Features of Severe COVID-19: a Systematic Review and Meta-analysis. Eur J Clin Invest. 2020;50(10):e13378. PubMed PMID: 32860457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Features of severe COVID-19: A systematic review and meta-analysis. AU - Del Sole,Francesco, AU - Farcomeni,Alessio, AU - Loffredo,Lorenzo, AU - Carnevale,Roberto, AU - Menichelli,Danilo, AU - Vicario,Tommasa, AU - Pignatelli,Pasquale, AU - Pastori,Daniele, Y1 - 2020/08/29/ PY - 2020/06/30/received PY - 2020/08/03/revised PY - 2020/08/04/accepted PY - 2020/8/30/pubmed PY - 2020/10/3/medline PY - 2020/8/30/entrez KW - SARS-CoV-2 KW - d-dimer KW - infection KW - procalcitonin KW - severity KW - sex KW - thrombocytopenia SP - e13378 EP - e13378 JF - European journal of clinical investigation JO - Eur J Clin Invest VL - 50 IS - 10 N2 - BACKGROUND: 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 2794 patients, of whom 596 (21.33%) had severe disease. A slightly higher age was found in severe vs 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. CONCLUSION: Characteristics associated with the severity of SARS-CoV-2 infection may allow an early identification and management of patients with poor outcomes. SN - 1365-2362 UR - https://www.unboundmedicine.com/medline/citation/32860457/Features_of_severe_COVID_19:_A_systematic_review_and_meta_analysis_ L2 - https://doi.org/10.1111/eci.13378 DB - PRIME DP - Unbound Medicine ER -