Clinical and laboratory factors associated with coronavirus disease 2019 (Covid-19): A systematic review and meta-analysis

Rev Med Virol. 2021 Nov;31(6):e2288. doi: 10.1002/rmv.2288. Epub 2021 Sep 2.

Abstract

SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.

Keywords: ARDS; Covid-19; SARS-CoV-2; critical; death; laboratory; mild; pneumonia; radiology; symptomatology.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • COVID-19 / mortality
  • COVID-19 / pathology*
  • COVID-19 / virology
  • COVID-19 Drug Treatment
  • Comorbidity
  • Cough / drug therapy
  • Cough / mortality
  • Cough / pathology*
  • Cough / virology
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / physiopathology
  • Dyspnea / drug therapy
  • Dyspnea / mortality
  • Dyspnea / pathology*
  • Dyspnea / virology
  • Fatigue / drug therapy
  • Fatigue / mortality
  • Fatigue / pathology*
  • Fatigue / virology
  • Fever / drug therapy
  • Fever / mortality
  • Fever / pathology*
  • Fever / virology
  • Humans
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Immunologic Factors / therapeutic use
  • Prognosis
  • Respiratory Distress Syndrome / diagnosis
  • Respiratory Distress Syndrome / physiopathology
  • SARS-CoV-2 / pathogenicity*
  • Severity of Illness Index
  • Smoking / physiopathology
  • Survival Analysis

Substances

  • Antiviral Agents
  • Immunologic Factors