Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia

Li, Jia; He, Xue; Yuanyuan; Zhang, Wei; Li, Xue; Zhang, Yuhua; Li, Shaoxiang; Guan, Chunyan; Gao, Zifen; Dong, Gehong

OBJECTIVE: We aimed to investigate the relationship between clinical characteristics, outcomes and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. METHODS: We performed a systematic review and meta-analysis using PubMed, Embase, and Cochrane Library databases to assess the clinical characteristics and outcomes of confirmed COVID-19 cases and compared severe (ICU) and non-severe (non-ICU) groups. RESULTS: We included 12 cohort studies including 2445 patients with COVID-19. Compared with non-severe (non-ICU) patients, severe (ICU) disease was associated with a smoking history (P=0.003) and comorbidities including chronic obstructive pulmonary disease (OR=5.08, P<0.001), diabetes (OR=3.17, P<0.001), hypertension (OR=2.40, P<0.001), coronary heart disease (OR=2.66, P<0.001), cerebrovascular diseases (OR=2.68, P=0.008), and malignancy (OR=2.21, P=0.040). We found significant differences between the two groups for fever, dyspnea, decreased lymphocyte and platelet counts, and increased leukocyte count, C-creative protein, procalcitonin, lactose dehydrogenase, aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and creatinine levels (P<0.05). Significant differences were also observed for multiple treatments (P<0.05). Patients in the severe (ICU) group were more likely to have complications and had a much higher mortality rate and lower discharge rate than those with non-severe (non-ICU) disease (P<0.05). CONCLUSIONS: Investigation of clinical characteristics and outcomes of severe cases of COVID-19 will contribute to early prediction, accurate diagnosis, and treatment to improve the prognosis of patients with severe illness.