The De Ritis ratio as prognostic biomarker of in‐hospital mortality in COVID‐19 patients

Zinellu, Angelo; Arru, Francesco; Vito, Andrea De; Sassu, Alessandro; Valdes, Giovanni; Scano, Valentina; Zinellu, Elisabetta; Perra, Roberto; Madeddu, Giordano; Carru, Ciriaco; Pirina, Pietro; Mangoni, Arduino A.; Babudieri, Sergio; Fois, Alessandro Giuseppe

doi:10.1111/eci.13427

Cited by 58 publications

(89 citation statements)

References 44 publications

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“…Nineteen studies defined outcomes as disease severity 22 , 27 – 30 , 37 – 39 , 42 , 43 , 46 – 50 , 58 , 60 , 62 , 63 . Seventeen studies defined outcomes as death 21 , 33 , 40 , 44 , 45 , 51 – 57 , 59 , 65 – 68 . Four studies used both disease severity and death 26 , 41 , 61 , 64 .…”

Section: Resultsmentioning

confidence: 99%

Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis

Umnuaypornlert¹,

Kanchanasurakit²,

Lucero‐Prisno³

et al. 2021

Tob. Induc. Dis.

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INTRODUCTION COVID-19 has major effects on the clinical, humanistic and economic outcomes among patients, producing severe symptoms and death. Smoking has been reported as one of the factors that increases severity and mortality rate among COVID-19 patients. However, the effect of smoking on such medical outcomes is still controversial. This study conducted a comprehensive systematic review and meta-analysis (SR/MA) on the association between smoking and negative outcomes among COVID-19 patients. METHODS Electronic databases, including PubMed, EMBASE, Cochrane Library, Science Direct, Google Scholar, were systematically searched from the initiation of the database until 12 December 2020. All relevant studies about smoking and COVID-19 were screened using a set of inclusion and exclusion criteria. The Newcastle–Ottawa Scale was used to assess the methodological quality of eligible articles. Random meta-analyses were conducted to estimate odds ratios (ORs) with 95% confidence interval (CIs). Publication bias was assessed using the funnel plot, Begg’s test and Egger’s test. RESULTS A total of 1248 studies were retrieved and reviewed. A total of 40 studies were finally included for meta-analysis. Both current smoking and former smoking significantly increase the risk of disease severity (OR=1.58; 95% CI: 1.16–2.15, p=0.004; and OR=2.48; 95% CI: 1.64–3.77, p<0.001; respectively) with moderate appearance of heterogeneity. Similarly, current smoking and former smoking also significantly increase the risk of death (OR=1.35; 95% CI: 1.12–1.62, p=0.002; and OR=2.58; 95% CI: 2.15–3.09, p<0.001; respectively) with moderate appearance of heterogeneity. There was no evidence of publication bias, which was tested by the funnel plot, Begg’s test and Egger’s test. CONCLUSIONS Smoking, even current smoking or former smoking, significantly increases the risk of COVID-19 severity and death. Further causational studies on this association and ascertianing the underlying mechanisms of this relation is warranted.

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Section: Resultsmentioning

confidence: 99%

Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis

Umnuaypornlert¹,

Kanchanasurakit²,

Lucero‐Prisno³

et al. 2021

Tob. Induc. Dis.

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“…After full-text review of the remaining 78 articles, a further 11 studies were excluded because they did not meet the inclusion criteria. Thus, 67 studies were included in the meta-analysis [ 20 – 86 ]. The characteristics of these studies, all published in 2020, are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were prospective [ 29 , 41 , 52 ], 51 retrospective [ 20 – 28 , 30 – 34 , 36 – 39 , 42 – 46 , 48 – 51 , 53 , 54 , 57 – 60 , 62 , 63 , 65 , 66 , 69 – 76 , 78 , 80 , 81 , 83 – 86 ], while 13 did not specifically declare the study design [ 23 , 35 , 40 , 47 , 55 , 56 , 61 , 64 , 67 , 68 , 77 , 79 , 82 ]. Fifty-two studies (77.6%) were performed in China [ 22 , 24 – 26 , 28 – 31 , 33 – 35 , 37 – 43 , 46 – 57 , 59 , 62 – 64 , 68 – 85 ] while the remaining 15 were conducted in the rest of the world [ 20 , 21 , 23 , 27 , 32 , 36 , 44 , 45 , 58 , 60 , 61 ...…”

Section: Resultsmentioning

confidence: 99%

“…Fifty-two studies (77.6%) were performed in China [ 22 , 24 – 26 , 28 – 31 , 33 – 35 , 37 – 43 , 46 – 57 , 59 , 62 – 64 , 68 – 85 ] while the remaining 15 were conducted in the rest of the world [ 20 , 21 , 23 , 27 , 32 , 36 , 44 , 45 , 58 , 60 , 61 , 65 – 67 , 86 ]. Endpoints included disease severity based on current clinical guidelines (31 studies, 46%) [ 22 , 24 , 28 , 32 , 33 , 35 , 36 , 38 , 39 , 44 – 47 , 49 – 52 , 54 , 56 , 58 , 64 , 66 , 69 , 72 , 73 , 75 , 77 , 79 , 81 – 83 ], survival (19 studies, 28%) [ 20 , 23 , 26 , 30 , 31 , 34 , 42 , 53 , 59 – 62 , 65 , …”

Section: Resultsmentioning

confidence: 99%

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Serum albumin concentrations are associated with disease severity and outcomes in coronavirus 19 disease (COVID-19): a systematic review and meta-analysis

et al. 2021

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Coronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the most threatening pandemic in modern history. The aim of this systematic review and meta-analysis was to investigate the associations between serum albumin concentrations and COVID-19 disease severity and adverse outcomes. A systematic literature search was conducted in PubMed, from inception to October 30, 2020. Sixty-seven studies in 19,760 COVID-19 patients (6141 with severe disease or poor outcome) were selected for analysis. Pooled results showed that serum albumin concentrations were significantly lower in patients with severe disease or poor outcome (standard mean difference, SMD: − 0.99 g/L; 95% CI, − 1.11 to − 0.88, p < 0.001). In multivariate meta-regression analysis, age (t = − 2.13, p = 0.043), publication geographic area (t = 2.16, p = 0.040), white blood cell count (t = − 2.77, p = 0.008) and C-reactive protein (t = − 2.43, p = 0.019) were significant contributors of between-study variance. Therefore, lower serum albumin concentrations are significantly associated with disease severity and adverse outcomes in COVID-19 patients. The assessment of serum albumin concentrations might assist with early risk stratification and selection of appropriate care pathways in this group.

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“…Previous study found that the ratio of AST/ALT was a predictor for hospital mortality in patients with COVID-19 [ 30 ]. However, our study did not find any significant difference in the ratio of AST/ALT in patients with oxygen therapy and the ones without.…”

Section: Discussionmentioning

confidence: 99%

The independent factors associated with oxygen therapy in COVID-19 patients under 65 years old

Wang

Liang

et al. 2021

PLoS ONE

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Background The number of hospitalized young coronavirus disease 2019 (COVID-19) patients has increased significantly. However, specific data about COVID-19 patients under 65 years old who are admitted to the hospital are scarce. Methods The COVID-19 patients under 65 years old who were admitted to the hospital in Sichuan Province, Renmin Hospital of Wuhan University, and Wuhan Red Cross Hospital were included in this study. Demographic information, laboratory data and clinical treatment courses were extracted from electronic medical records. Risk factors associated with oxygen therapy were explored. Results Eight hundred thirty-three COVID-19 patients under 65 years old were included. Of the included patients, 29.4% had one or more comorbidities. Oxygen therapy was required in 63.1% of these patients, and the mortality was 2.9% among the oxygen therapy patients. Fever (odds ratio [OR] 2.072, 95% confidence interval [CI] 1.312–3.271, p = 0.002), dyspnea (OR 2.522, 95% CI 1.213–5.243, p = 0.013), chest distress (OR 2.278, 95% CI 1.160–4.473, p = 0.017), elevated respiratory rate (OR 1.114, 95% CI 1.010–1.228, p = 0.031), and decreased albumin (OR 0.932, 95% CI 0.880–0.987, p = 0.016) and globulin levels (OR 0.929, 95% 0.881–0.980, p = 0.007) were independent factors related to oxygen therapy. Conclusions Oxygen therapy is highly required in COVID-19 patients under 65 years old who are admitted to the hospital, but the success rate is high. Respiratory failure-related symptoms, elevated respiratory rate, low albumin and globulin levels, and fever at admission are independent risk factors related to the requirement of oxygen.

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The De Ritis ratio as prognostic biomarker of in‐hospital mortality in COVID‐19 patients

Cited by 58 publications

References 44 publications

Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis

Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis

Serum albumin concentrations are associated with disease severity and outcomes in coronavirus 19 disease (COVID-19): a systematic review and meta-analysis

The independent factors associated with oxygen therapy in COVID-19 patients under 65 years old

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