Mudatsir, - and Jonny Karunia Fajar, - and Laksmi Wulandari, - and Gatot Soegiarto, - and Muhammad Ilmawan, - and Yeni Purnamasari, - and Bagus Aulia Mahdi, - and Galih Dwi Jayanto, - and Suhendra, - and Yennie Ayu Setianingsih, - and Romi Hamdani, - and Daniel Alexander Suseno, - and Kartika Agustina, - and Hamdan Yuwafi Naim, - and Muchamad Muchlas, - and Hamid Hunaif Dhofi Alluza, - and Nikma Alfi Rosida, - and Mayasari, - and Mustofa, - and Adam Hartono, - and Richi Aditya, - and Firman Prastiwi, - and Fransiskus Xaverius Meku, - and Monika Sitio, - and Abdullah Azmy, - and Anita Surya Santoso, - and Radhitio Adi Nugroho, - and Camoya Gersom, - and Ali A. Rabaan, - and Sri Masyeni, - and Firzan Nainu, - and Abram L. Wagner, - and Kuldeep Dhama, - and Harapan, - (2020) Predictors of COVID-19 severity: a systematic review and meta-analysis [version 1; peer review: 2 approved]. F1000Research, 9 (1107). pp. 1-26. ISSN 20461402

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Abstract

Background: The unpredictability of the progression of coronavirus disease 2019 (COVID-19) may be attributed to the low precision of the tools used to predict the prognosis of this disease. Objective: To identify the predictors associated with poor clinical outcomes in patients with COVID-19. Methods: Relevant articles from PubMed, Embase, Cochrane, and Web of Science were searched and extracted as of April 5, 2020. Data of interest were collected and evaluated for their compatibility for the meta-analysis. Cumulative calculations to determine the correlation and effect estimates were performed using the Z test. Results: In total, 19 papers recording 1,934 mild and 1,644 severe cases of COVID-19 were included. Based on the initial evaluation, 62 potential risk factors were identified for the meta-analysis. Several comorbidities, including chronic respiratory disease, cardiovascular disease, diabetes mellitus, and hypertension were observed more frequent among patients with severe COVID-19 than with the mild ones. Compared to the mild form, severe COVID-19 was associated with symptoms such as dyspnea, anorexia, fatigue, increased respiratory rate, and high systolic blood pressure. Lower levels of lymphocytes and hemoglobin; elevated levels of leukocytes, aspartate aminotransferase, alanine aminotransferase, blood creatinine, blood urea nitrogen, high-sensitivity troponin, creatine kinase, high-sensitivity C-reactive protein, interleukin 6, D-dimer, ferritin, lactate dehydrogenase, and procalcitonin; and a high erythrocyte sedimentation rate were also associated with severe COVID-19. Conclusion: More than 30 risk factors are associated with a higher risk of severe COVID-19. These may serve as useful baseline parameters in the development of prediction tools for COVID-19 prognosis.

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