Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland; Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland.
Travel Med Infect Dis. 2020 Sep-Oct;37:101825. doi: 10.1016/j.tmaid.2020.101825. Epub 2020 Aug 4.
Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a world-wide pandemic with an enormous medical and societal-economic toll. Thus, our aim was to gather all available information regarding comorbidities, clinical signs and symptoms, outcomes, laboratory findings, imaging features, and treatments in patients with coronavirus disease 2019 (COVID-19).
EMBASE, PubMed/Medline, Scopus, and Web of Science were searched for studies published in any language between December 1st, 2019 and March 28th, 2020. Original studies were included if the exposure of interest was an infection with SARS-CoV-2 or confirmed COVID-19. The primary outcome was the risk ratio of comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatments, outcomes, and complications associated with COVID-19 morbidity and mortality. We performed random-effects pairwise meta-analyses for proportions and relative risks, I, T, and Cochrane Q, sensitivity analyses, and assessed publication bias.
148 studies met the inclusion criteria for the systematic review and meta-analysis with 12'149 patients (5'739 female) and a median age of 47.0 [35.0-64.6] years. 617 patients died from COVID-19 and its complication. 297 patients were reported as asymptomatic. Older age (SMD: 1.25 [0.78-1.72]; p < 0.001), being male (RR = 1.32 [1.13-1.54], p = 0.005) and pre-existing comorbidity (RR = 1.69 [1.48-1.94]; p < 0.001) were identified as risk factors of in-hospital mortality. The heterogeneity between studies varied substantially (I; range: 1.5-98.2%). Publication bias was only found in eight studies (Egger's test: p < 0.05).
Our meta-analyses revealed important risk factors that are associated with severity and mortality of COVID-19.
自 2019 年 12 月以来，一种新型冠状病毒（SARS-CoV-2）引发了全球大流行，给医疗和社会经济带来了巨大的影响。因此，我们的目的是收集所有关于合并症、临床症状和体征、结局、实验室检查结果、影像学特征和 2019 冠状病毒病（COVID-19）患者治疗的可用信息。
我们在 EMBASE、PubMed/Medline、Scopus 和 Web of Science 上检索了 2019 年 12 月 1 日至 2020 年 3 月 28 日期间以任何语言发表的研究。如果感兴趣的暴露是 SARS-CoV-2 感染或确诊的 COVID-19，则纳入原始研究。主要结局是与 COVID-19 发病率和死亡率相关的合并症、临床症状和体征、实验室检查结果、影像学特征、治疗、结局和并发症的风险比。我们对比例和相对风险、I、T 和 Cochrane Q 进行了随机效应成对荟萃分析、敏感性分析，并评估了发表偏倚。
148 项研究符合系统评价和荟萃分析的纳入标准，共纳入 12149 例患者（5739 例女性），中位年龄为 47.0 [35.0-64.6] 岁。617 例患者死于 COVID-19 及其并发症。297 例患者报告为无症状。年龄较大（SMD：1.25 [0.78-1.72]；p<0.001）、男性（RR=1.32 [1.13-1.54]，p=0.005）和合并症（RR=1.69 [1.48-1.94]；p<0.001）是住院死亡率的危险因素。研究之间的异质性差异很大（I；范围：1.5-98.2%）。仅在八项研究中发现发表偏倚（Egger 检验：p<0.05）。
我们的荟萃分析揭示了与 COVID-19 严重程度和死亡率相关的重要危险因素。
