Risk factors for death in 1859 subjects with COVID-19

Chen, Lei; Yu, Jianming; He, Weichun; Chen, Li; Yuan, Guolin; Dong, Fang; Chen, Wenlan; Cao, Yulin; Yang, Jingyan; Cai, Liling; Wu, Di; Ran, Qijie; Li, Lei; Liu, Qiaomei; Ren, Wenxiang; Gao, Fei; Wang, Hongxiang; Chen, Zhichao; Gale, Robert Peter; Li, Qiubai; Hu, Yu

doi:10.1038/s41375-020-0911-0

Cited by 115 publications

(132 citation statements)

References 44 publications

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“…At national and at province level (Lima), the age at infection was 20 years lower than the age at death due to COVID-19. This higher mortality risk for older people has been reported previously [25,26]. In our study, the association between older age and COVID-19 mortality risk was unaffected by increasing levels of PM 2.5 , suggesting that the factors that explain the higher mortality risk with age are independent of PM 2.5 exposure.…”

Section: Discussionsupporting

confidence: 82%

Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis

Vasquez-Apestegui

Parras-Garrido

Tapia

et al. 2020

Preprint

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Abstract Background Corona virus disease (COVID-19) originated in China in December 2019. Thereafter, a global logarithmic expansion of the cases has occurred. Some countries have a higher rate of infections despite of early implementation of quarantine. Air pollution could be related to the high susceptibility to SARS-CoV-2 and the associated case-fatality rates (deaths/cases*100). Lima, Peru has the second highest incidence of COVID-19 in Latin America and it is also one of the cities with highest levels of air pollution in the Region. Methods This study investigated the association of the levels of PM2.5 exposure in the previous years (2010–2016) in 24 districts of Lima with the cases, deaths and case-fatality rates of COVID-19. Results Until June 12, 2020, there were 6,308 deaths and 220,749 SARS-CoV-2 positive cases in Peru. In Lima, the total number of COVID-19 deaths in all metropolitan areas was 2,382. The case-fatality rate at the national level was 2.58% and 1.93% in Lima. Higher PM2.5 levels are associated with higher number of cases and deaths of COVID-19. The case-fatality rate (Deaths/cases*100) did not increase with the increase in PM2.5 levels. A higher number of food markets was associated with higher incidence and mortality of COVID-19 (p < 0.01 for both); these associations persisted when cases (r = 0.49; p < 0.01) and deaths (r = 0.58; p < 0.01) were adjusted by the population density. The association of PM2.5 with cases of COVID-19 was maintained after controlling analysis by age, sex and number of food markers. Conclusions the higher rates of COVID-19 in Metropolitan Lima is attributable, among others, to the increased PM2.5 exposure in the previous years after adjusting for age, sex and number of food markets. Reduction of air pollution since a long term perspective, and social distancing are needed to prevent spreads of virus outbreak.

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Section: Discussionsupporting

confidence: 82%

Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis

Vasquez-Apestegui

Parras-Garrido

Tapia

et al. 2020

Preprint

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“…The history of smoking among COVID-19 patients increased the risk of mortality. From a study, it was found that smokers had a 767% higher risk of mortality as non-smoker [32,33,74].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis

2020

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Objectives The main aim of this study was to find the prevalence of mortality among hospitalized COVID-19 infected patients and associated risk factors for death. Methods Three electronic databases including PubMed, Science Direct and Google Scholar were searched to identify relevant cohort studies of COVID-19 disease from January 1, 2020, to August 11, 2020. A random-effects model was used to calculate pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures. Cochrane chi-square test statistic Q, I 2 , and 2 tests were used to measure the presence of heterogeneity. Publication bias and sensitivity of the included studies were also tested. Results In this meta-analysis, a total of 58 studies with 122,191 patients were analyzed. The pooled prevalence rate of mortality among the hospitalized COVID-19 patients was 18.88%, 95% CI (16.46-21.30), p < 0.001. Highest mortality was found in Europe [PR 26.85%, 95% CI (19.41-34.29), p < 0.001] followed by North America [PR 21.47%, 95% CI (16.27-26.68), p < 0.001] and Asia [PR 14.83%, 95% CI (12.46-17.21), p < 0.001]. An significant association were found between mortality among COVID-19 infected patients and older age (> 65 years vs. < 65 years) [RR 3.59, 95% CI (1.87-6.90), p < 0.001], gender (male vs. female) [RR 1.63, 95% CI (1.43-1.87), p < 0.001], ICU admitted patients [RR 3.72, 95% CI (2.70-5.13), p < 0.001], obesity [RR 2.18, 95% CI (1.10-4.34), p < 0.05], hypertension [RR 2.08,95% CI (1.79-2.43) p < 0.001], diabetes [RR 1.87, 95% CI (1.23-2.84), p < 0.001], cardiovascular disease [RR 2.51, 95% CI (1.20-5.26), p < 0.05], and cancer [RR 2.31, 95% CI (1.80-2.97), p < 0.001]. In addition, significant association for high risk of mortality were also found for cerebrovascular disease, COPD, coronary heart disease, chronic renal disease, chronic liver disease, chronic lung disease and chronic kidney disease. Conclusion This meta-analysis revealed that the mortality rate among COVID-19 patients was highest in the European region and older age, gender, ICU patients, patients with comorbidity had a high risk for case fatality. Those findings would help the health care providers to reduce the mortality rate and combat this pandemic to save lives using limited resources.

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“…The Newcastle-Ottawa scale was applied for the quality assessment (supplementary data, Table S1) of studies included in the quantitative synthesis of mortality in COVID-19 patients with ARDS. Of the 25 original studies included in the metaanalysis, 16 studies were deemed 'good' studies with a score of seven points [31,[33][34][35]40,41,[44][45][46]49,50,52,53,56,58,60] ( Table 1). Whereas the remaining 9 studies were regarded as 'fair' with a score of 6 points [32,36,39,43,48,54,59,61,62] (Table 1).…”

Section: Quality Assessmentmentioning

confidence: 99%

“…The remaining six studies were originated from Spain (n = 2) [63,64], Canada (n = 1) [57], United States (n = 1) [65], Japan (n = 1) [66], and Korea (n = 1) [67]. Furthermore, 10 out of 23 studies are multicenter [34,35,41,[44][45][46][47]49,54,67], while the remaining 13 studies are single-center [31,33,37,38,40,42,51,52,57,[63][64][65][66]. Except for three studies [57,65,66] which included exclusively COVID-19 patients who received corticosteroids, the crude prevalence of corticosteroid use in the remaining 20 studies ranged from 22% to 90%, with a median prevalence of 53% (lower quartile: 29%; upper quartile: 66%).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis

Hasan

Capstick

Ahmed³

et al. 2020

Expert Review of Respiratory Medicine

220

195

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Objectives: The acute respiratory distress syndrome (ARDS) secondary to viral pneumonitis is one of the main causes of high mortality in patients with COVID-19 (novel coronavirus disease 2019). We systematically reviewed mortality in COVID-19 patients with ARDS and the potential role of systemic corticosteroids in COVID-19 patients. Methods: Electronic databases and country-specific healthcare databases were searched to identify relevant studies/reports. The quality assessment of individual studies was conducted using the Newcastle-Ottawa Scale. Country-specific proportion of individuals with COVID-19 who developed ARDS and reported death were combined in a random-effect meta-analysis to give a pooled mortality estimate of ARDS. Results: The overall pooled mortality estimate among 10,815 ARDS cases in COVID-19 patients was 39% (95% CI: 23-56%). The pooled mortality estimate for China was 69% (95% CI: 67-72%). In Europe, the highest mortality estimate among COVID-19 patients with ARDS was reported in Poland (73%; 95% CI: 58-86%) while Germany had the lowest mortality estimate (13%; 95% CI: 2-29%) among COVID-19 patients with ARDS. The median crude mortality rate of COVID-19 patients with reported corticosteroid use was 28.0% (lower quartile: 13.9%; upper quartile: 53.6%). Conclusions: The high mortality in COVID-19 associated ARDS necessitates a prompt and aggressive treatment strategy which includes corticosteroids. Most of the studies included no information on the dosing regimen of corticosteroid therapy, however, low-dose corticosteroid therapy or pulse corticosteroid therapy appears to have a beneficial role in the management of severely ill COVID-19 patients.

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Risk factors for death in 1859 subjects with COVID-19

Cited by 115 publications

References 44 publications

Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis

Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis

Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis

Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis

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