Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
J Intensive Care Med. 2023 Sep;38(9):825-837. doi: 10.1177/08850666231166344. Epub 2023 Mar 28.
This study aims to investigate the risk factors associated with severity and death from COVID-19 through a systematic review and meta-analysis of the published documents in Iran. A systematic search was performed based on all articles indexed in Scopus, Embase, Web of Science (WOS), PubMed, and Google Scholar in English and Scientific Information Database (SID) and Iranian Research Institute for Information Science and Technology (IRA)NDOC indexes in Persian. To assess quality, we used the Newcastle Ottawa Scale. Publication bias was assessed using Egger's tests. Forest plots were used for a graphical description of the results. We used HRs, and ORs reported for the association between risk factors and COVID-19 severity and death. Sixty-nine studies were included in the meta-analysis, of which 62 and 13 had assessed risk factors for death and severity, respectively. The results showed a significant association between death from COVID-19 and age, male gender, diabetes, hypertension, cardiovascular disease (CVD), cerebrovascular disease, chronic kidney disease (CKD), Headache, and Dyspnea. We observed a significant association between increased white blood cell (WBC), decreased Lymphocyte, increased blood urea nitrogen (BUN), increased creatinine, vitamin D deficiency, and death from COVID-19. There was only a significant relationship between CVD and disease severity. It is recommended that the predictive risk factors of COVID-19 severity and death mentioned in this study to be used for therapeutic and health interventions, to update clinical guidelines and determine patients' prognoses.
本研究旨在通过对伊朗已发表文献的系统评价和荟萃分析,调查与 COVID-19 严重程度和死亡相关的风险因素。我们在 Scopus、Embase、Web of Science (WOS)、PubMed 和 Google Scholar 等英文数据库以及 Scientific Information Database (SID) 和 Iranian Research Institute for Information Science and Technology (IRA)NDOC 等波斯文数据库中进行了全面检索。我们使用纽卡斯尔-渥太华量表评估质量。使用 Egger 检验评估发表偏倚。森林图用于结果的图形描述。我们使用报告的风险因素与 COVID-19 严重程度和死亡之间关联的 HR 和 OR。荟萃分析共纳入 69 项研究,其中 62 项和 13 项分别评估了死亡和严重程度的风险因素。结果表明,COVID-19 死亡与年龄、男性、糖尿病、高血压、心血管疾病 (CVD)、脑血管疾病、慢性肾脏病 (CKD)、头痛和呼吸困难显著相关。我们观察到白细胞增多 (WBC)、淋巴细胞减少、血尿素氮 (BUN) 升高、肌酐升高、维生素 D 缺乏与 COVID-19 死亡显著相关。只有 CVD 与疾病严重程度存在显著关系。建议将本研究中提到的 COVID-19 严重程度和死亡的预测风险因素用于治疗和健康干预,以更新临床指南并确定患者的预后。