Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis

Objectives COVID-19 has a varied clinical presentation. Elderly patients with comorbidities are more vulnerable to severe disease. This study identifies specific symptoms and comorbidities predicting severe COVID-19 and intensive care unit (ICU) admission. Methods A literature search identified stud...

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Bibliographic Details
Published in:International journal of public health Vol. 65; no. 5; pp. 533 - 546
Main Authors: Jain, Vageesh, Yuan, Jin-Min
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01.06.2020
Springer Nature B.V
Subjects:
Betacoronavirus
Cardiovascular disease
Cardiovascular Diseases - complications
Chronic obstructive pulmonary disease
Comorbidity
Coronavirus Infections - complications
Coronaviruses
COVID-19
Critical Care
Dyspnea
Environmental Health
Hospitalization
Humans
Hypertension
Hypertension - complications
Intensive care
Intensive Care Units
Medicine
Medicine & Public Health
Meta-analysis
Occupational Medicine/Industrial Medicine
Pandemics
Pneumonia, Viral - complications
Public Health
Pulmonary Disease, Chronic Obstructive - complications
Review
SARS-CoV-2
COVID-19
Disease severity
Novel coronavirus
Epidemiology
Public health
Risk factors
ISSN:1661-8556, 1661-8564, 1661-8564
Online Access:Get full text
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Summary:Objectives COVID-19 has a varied clinical presentation. Elderly patients with comorbidities are more vulnerable to severe disease. This study identifies specific symptoms and comorbidities predicting severe COVID-19 and intensive care unit (ICU) admission. Methods A literature search identified studies indexed in MEDLINE, EMBASE and Global Health before 5th March 2020. Two reviewers independently screened the literature and extracted data. Quality appraisal was performed using STROBE criteria. Random effects meta-analysis identified symptoms and comorbidities associated with severe COVID-19 or ICU admission. Results Seven studies (including 1813 COVID-19 patients) were included. ICU patients were older (62.4 years) than non-ICU (46 years), with a greater proportion of males. Dyspnoea was the only symptom predictive for severe disease (pOR 3.70, 95% CI 1.83–7.46) and ICU admission (pOR 6.55, 95% CI 4.28–10.0). COPD was the strongest predictive comorbidity for severe disease (pOR 6.42, 95% CI 2.44–16.9) and ICU admission (pOR 17.8, 95% CI 6.56–48.2), followed by cardiovascular disease and hypertension. Conclusions Dyspnoea was the only symptom predictive for severe COVID-19 and ICU admission. Patients with COPD, cardiovascular disease and hypertension were at higher risk of severe illness and ICU admission.
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ISSN:1661-8556
1661-8564
1661-8564
DOI:10.1007/s00038-020-01390-7