Just launched - feedback most welcome!
Send feedback

COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Back to homepage

Manuscript Zhang JJY, Lee KS, Ang LW, et al. Risk Factors of Severe Disease and Efficacy of Treatment in Patients Infected with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression Analysis. Clin Infect Dis. 2020 May 14. pii: 5837140. doi: 10.1093/cid/ciaa576.
Abstract

The coronavirus disease 2019 (COVID-19) pandemic spread globally in the beginning of 2020. At present, predictors of severe disease and the efficacy of different treatments are not well-understood. We conducted a systematic review and meta-analysis of all published studies up to March 15, 2020 which reported COVID-19 clinical features and/or treatment outcomes. 45 studies reporting 4203 patients were included. Pooled rates of intensive care unit (ICU) admission, mortality and acute respiratory distress syndrome (ARDS) were 10.9%, 4.3% and 18.4%, respectively. On meta-regression, ICU admission was predicted by raised leukocyte count (p<0.0001), raised alanine aminotransferase (p=0.024), raised aspartate transaminase (p=0.0040), elevated lactate dehydrogenase (LDH) (p<0.0001) and increased procalcitonin (p<0.0001). ARDS was predicted by elevated LDH (p<0.0001), while mortality was predicted by raised leukocyte count (p=0.0005) and elevated LDH (p<0.0001). Treatment with lopinavir-ritonavir showed no significant benefit in mortality and ARDS rates. Corticosteroids were associated with a higher rate of ARDS (p=0.0003).

Ratings
Discipline / Specialty Area Score
This article is currently under review