Purpose: Coronavirus disease 2019 (COVID-19) is an emerging disease that was first reported in Wuhan city, the capital of Hubei province in China, and has subsequently spread worldwide. Risk factors for mortality have not been well summarized. Current meta-analysis of retrospective cohort studies was done to summarize available findings on the association between age, gender, comorbidities and risk of death from COVID-19 infection. Methods: Online databases including Web of Science, PubMed, Scopus, Cochrane Library and Google scholar were searched to detect relevant publications up to 1 May 2020, using relevant keywords. To pool data, random-effects model was used. Furthermore, sensitivity analysis and publication bias test were also done. Results: In total, 14 studies with 29,909 COVID-19 infected patients and 1445 cases of death were included in the current meta-analysis. Significant associations were found between older age (65 vs <65 years old) (pooled ORs ¼ 4.59, 95%CIs ¼ 2.61-8.04, p < .001), gender (male vs female) (pooled ORs ¼ 1.50, 95%CIs ¼ 1.06-2.12, p ¼ .021) and risk of death from COVID-19 infection. In addition, hypertension (pooled ORs ¼ 2.70, 95%CIs ¼ 1.40-5.24, p ¼ .003), cardiovascular diseases (CVDs) (pooled ORs ¼ 3.72, 95%CIs ¼ 1.77-7.83, p ¼ .001), diabetes (pooled ORs ¼ 2.41, 95%CIs ¼ 1.05-5.51, p ¼ .037), chronic obstructive pulmonary disease (COPD) (pooled ORs ¼ 3.53, 95%CIs ¼ 1.79-6.96, p < .001) and cancer (pooled ORs ¼ 3.04, 95%CIs ¼ 1.80-5.14, p < .001), were associated with higher risk of mortality. Conclusions: Older age (65 years old), male gender, hypertension, CVDs, diabetes, COPD and malignancies were associated with greater risk of death from COVID-19 infection. These findings could help clinicians to identify patients with poor prognosis at an early stage.

24Background: Coronavirus disease 2019 is an emerging disease that was first reported 25 in Wuhan city, the capital of Hubei province in China, and has subsequently spread worldwide. 26Risk factors for mortality have not been well summarized. Current meta-analysis of retrospective 27 cohort studies was done to summarize available findings on the association between age, gender, 28 comorbidities and risk of death from COVID-19 infection. 29 Methods: Online databases including Web of Science, PubMed, Scopus and Google scholar were 30 searched to detect relevant publications up to 22 March 2020, using relevant keywords. To pool 31 data, random-effects model was used. Furthermore, sensitivity analysis and publication bias test 32 were also done. 33 Results: In total, six retrospective studies with 22,350 COVID-19 infected patients and 741 cases 34 of death were included in the current meta-analysis. A significant positive association was found 35 between older age (≥65 years old) and COVID-19 mortality (combined effect size=2.39 (over 36 twofold), 95% CIs=1.75-3.28, p<0.001). Such finding was also seen for hypertension (combined 37 effect size=3.29 (over threefold), 95% CIs=1.54-7.05, p=0.002), diabetes (combined effect 38 size=3.11 (over threefold), 95% CIs=1.10-8.80, p=0.032), chronic obstructive pulmonary disease 39 (COPD) (combined effect size=7.69 (over sevenfold), 95% CIs=5.65-10.47, p<0.001) and 40 cardiovascular diseases (CVDs) (combined effect size=7.39 (over sevenfold), 95% CIs=2.88-41 18.96, p<0.001).42 Conclusions: Older age, hypertension, diabetes, COPD and CVDs were associated with greater 43 risk of death from COVID-19 infection. These findings could help clinicians to identify patients 44 with poor prognosis at an early stage.45

The associations of various dietary or circulating antioxidants with the risk of all-cause mortality in the general population have not been established yet. A systematic search was performed in PubMed and Scopus, from their inception up to October 2017. Prospective observational studies reporting risk estimates of all-cause mortality in relation to dietary intake and/or circulating concentrations of antioxidants were included. Random-effects meta-analyses were conducted. Forty-one prospective observational studies (total n = 507,251) involving 73,965 cases of all-cause mortality were included. The RRs of all-cause mortality for the highest compared with the lowest category of circulating antioxidant concentrations were as follows: total carotenes, 0.60 (95% CI: 0.46, 0.74); vitamin C, 0.61 (95% CI: 0.53, 0.69); selenium, 0.62 (95% CI: 0.45, 0.79); β-carotene, 0.63 (95% CI: 0.57, 0.70); α-carotene, 0.68 (95% CI: 0.58, 0.78); total carotenoids, 0.68 (95% CI: 0.56, 0.80); lycopene, 0.75 (95% CI: 0.54, 0.97); and α-tocopherol, 0.84 (95% CI: 0.77, 0.91). The RRs for dietary intakes were: total carotenoids, 0.76 (95% CI: 0.66, 0.85); total antioxidant capacity, 0.77 (95% CI: 0.73, 0.81); selenium, 0.79 (95% CI: 0.73, 0.85); α-carotene, 0.79 (95% CI: 0.63, 0.94); β-carotene, 0.82 (95% CI: 0.77, 0.86); vitamin C, 0.88 (95% CI: 0.83, 0.94); and total carotenes, 0.89 (95% CI: 0.81, 0.97). A nonsignificant inverse association was found for dietary zinc, zeaxanthin, lutein, and vitamin E. The nonlinear dose-response meta-analyses demonstrated a linear inverse association in the analyses of dietary β-carotene and total antioxidant capacity, as well as in the analyses of circulating α-carotene, β-carotene, selenium, vitamin C, and total carotenoids. The association appeared to be U-shaped in the analyses of serum lycopene and dietary vitamin C. The present study indicates that adherence to a diet with high antioxidant properties may reduce the risk of all-cause mortality. Our results confirm current recommendations that promote higher intake of antioxidant-rich foods such as fruit and vegetables.

Aim: The Coronavirus disease 2019 (COVID-19) outbreak is a major threat to human beings.Lung injury has been reported as the major outcome of COVID-19 infection. However, liver damage has also been considered to occur in severe cases. Current meta-analysis of retrospective studies was done to summarize available findings on the association between liver injury and severity of COVID-19 infection.Methods: Online databases including PubMed, Scopus, Web of Science and Cochrane Library were searched to detect relevant publications up to 1 April 2020, using relevant keywords. To pool data, a fixed-or random-effects model was used depending on the heterogeneity between studies. Furthermore, publication bias test and sensitivity analysis were also done.Results: In total, 20 retrospective studies with 3,428 COVID-19 infected patients (severe cases = 1,455 and mild cases = 1,973), were included in this meta-analysis. Higher serum levels of Aspartate aminotransferase (weighted mean difference = 8.84 U/L, 95% CI = 5.97 to 11.71, P<0.001), Alanine aminotransferase (weighted mean difference = 7.35 U/L, 95% CI = 4.77 to 9.93, P<0.001), total Bilirubin (weighted mean difference = 2.30 mmol/L, 95% CI = 1.24 to 3.36, P<0.001) and lower serum levels of Albumin (weighted mean difference = -4.24 g/L, 95% CI = -6.20 to -2.28, P<0.001), were associated with a significant increase in the severity of COVID-19 infection. This article is protected by copyright. All rights reserved.Conclusions: The incidence of liver injury, as assessed by serum analysis (AST, ALT, total Bilirubin and Albumin levels), seems to be higher in patients with severe COVID-19 infection.

Aim: The Coronavirus disease 2019 outbreak is a major threat to human beings.Lung injury has been reported as the major outcome of COVID-19 infection. However, liver damage has also been considered to occur in severe cases. Current meta-analysis of retrospective studies was done to summarize available findings on the association between liver injury and severity of COVID-19 infection.Methods: Online databases including PubMed, Scopus, Web of Science and Cochrane Library were searched to detect relevant publications up to 1 April 2020, using relevant keywords. To pool data, a fixed-or random-effects model was used depending on the heterogeneity between studies. Furthermore, publication bias test and sensitivity analysis were also done.Results: In total, 20 retrospective studies with 3,428 COVID-19 infected patients (severe cases = 1,455 and mild cases = 1,973), were included in this meta-analysis. Higher serum levels of Aspartate aminotransferase (weighted mean difference = 8.84 U/L, 95% CI = 5.97 to 11.71, P<0.001), Alanine aminotransferase (weighted mean difference = 7.35 U/L, 95% CI = 4.77 to 9.93, P<0.001), total Bilirubin (weighted mean difference = 2.30 mmol/L, 95% CI = 1.24 to 3.36, P<0.001) and lower serum levels of Albumin (weighted mean difference = -4.24 g/L, 95% CI = -6.20 to -2.28, P<0.001), were associated with a significant increase in the severity of COVID-19 infection.Conclusions: The incidence of liver injury seems to be higher in patients with severe COVID-19 infection. This finding could help physicians to identify patients with poor prognosis at an early stage.