Barek Md Abdul, Aziz Md Abdul, Islam Mohammad Safiqul
Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh.
Heliyon. 2020 Dec;6(12):e05684. doi: 10.1016/j.heliyon.2020.e05684. Epub 2020 Dec 15.
Severe acute respiratory coronavirus 2 (SARS-CoV-2) cases are overgrowing globally and now become a pandemic. A meta-analysis was conducted to evaluate the impact of age, sex, comorbidities, and clinical characteristics on the severity of COVID-19 to help diagnose and evaluate the current outbreak in clinical decision-making.
PubMed, ScienceDirect, and BMC were searched to collect data about demographic, clinical characteristics, and comorbidities of COVID-19 patients. Meta-analysis was conducted with Review Manager 5.3. Publication bias was assessed using Egger's test and Begg-Mazumdar's rank correlation.
Fifty-five studies were included in this meta-analysis, including 10014 patients with SARS-CoV-2 infection. Male cases and cases with an age of ≥50 years (OR = 2.41, p < 0.00001; RR = 3.36, p = 0.0002, respectively) were severely affected by SARS-CoV-2. Patients having age≥65 years are not associated (p = 0.110) with the severity of COVID-19. Presence of at least one comorbidity or hypertension, diabetes, cerebrovascular disease, cardiovascular diseases, respiratory disease, malignancy, chronic kidney disease and chronic liver diseases individually increased the severity of COVID-19 cases significantly (OR = 3.13, p < 0.00001; OR = 2.35, p < 0.00001; OR = 2.42, p < 0.00001; OR = 3.78, p < 0.00001; OR = 3.33, p < 0.00001; OR = 2.58, p < 0.00001; OR = 2.32, p < 0.00001; OR = 2.27, p = 0.0007; OR = 1.70, p = 0.003, respectively). Clinical manifestation such as fever, cough, fatigue, anorexia, dyspnea, chest tightness, hemoptysis, diarrhea and abdominal pain (OR = 1.68, p = 0.0001; OR = 1.41, p = 0.004; OR = 1.26, p = 0.03; OR = 2.38, p < 0.0001; OR = 4.30, p < 0.00001; OR = 2.11, p = 0.002; OR = 4.93, p < 0.0001; OR = 1.35, p = 0.03; OR = 2.38, p = 0.008, respectively) were significantly associated with the severity of cases. No association of severity was found with myalgia, pharyngalgia, nausea, vomiting, headache, dizziness and sore throat (p > 0.05). No publication bias was found in case of age (≥50 years, age≥65 years), comorbidities and clinical manifestations.
Males patients and elderly or older patients (age ≥50 years) are at higher risk of developing severity, whereas comorbidities and clinical manifestations could significantly affect the prognosis and severity of COVID-19.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病例在全球范围内不断增加，现已成为大流行病。进行了一项荟萃分析，以评估年龄、性别、合并症和临床特征对2019冠状病毒病（COVID-19）严重程度的影响，以帮助在临床决策中诊断和评估当前疫情。
检索PubMed、ScienceDirect和BMC，收集有关COVID-19患者的人口统计学、临床特征和合并症的数据。使用Review Manager 5.3进行荟萃分析。使用Egger检验和Begg-Mazumdar秩相关评估发表偏倚。
本荟萃分析纳入了55项研究，包括10014例SARS-CoV-2感染患者。男性病例和年龄≥50岁的病例（优势比[OR]=2.41，p<0.00001；风险比[RR]=3.36，p=0.0002）受SARS-CoV-2影响严重。年龄≥65岁的患者与COVID-19的严重程度无关（p=0.110）。至少有一种合并症或高血压、糖尿病、脑血管疾病、心血管疾病、呼吸系统疾病、恶性肿瘤、慢性肾脏病和慢性肝病单独显著增加了COVID-19病例的严重程度（OR分别为3.13，p<0.00001；2.35，p<0.000o1；2.42，p<0.00001；3.78，p<0.00001；3.33，p<0.00001；2.58，p<0.00001；2.32，p<0.00001；2.27，p=0.0007；1.70，p=0.003）。发热、咳嗽、疲劳、厌食、呼吸困难、胸闷、咯血、腹泻和腹痛等临床表现（OR分别为1.68，p=0.0001；1.41，p=0.004；1.26，p=0.03；2.38，p<0.0001；4.30，p<0.00001；2.11，p=0.002；4.93，p<0.0001；1.35，p=0.03；2.38，p=0.008）与病例的严重程度显著相关。未发现肌痛、咽痛、恶心、呕吐、头痛、头晕和咽痛与严重程度有关（p>0.05）。在年龄（≥50岁、≥65岁）、合并症和临床表现方面未发现发表偏倚。
男性患者和老年患者（年龄≥50岁）发生重症的风险较高，而合并症和临床表现可显著影响COVID-19的预后和严重程度。
