Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia

OBJECTIVE: We aimed to investigate the relationship between clinical characteristics, outcomes and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. METHODS: We performed a systematic review and meta-analysis using PubMed, Embase, and Cochrane Library databases to assess the clinical characteristics and outcomes of confirmed COVID-19 cases and compared severe (ICU) and non-severe (non-ICU) groups. RESULTS: We included 12 cohort studies including 2445 patients with COVID-19. Compared with non-severe (non-ICU) patients, severe (ICU) disease was associated with a smoking history (P=0.003) and comorbidities including chronic obstructive pulmonary disease (OR=5.08, P\u003c0.001), diabetes (OR=3.17, P\u003c0.001), hypertension (OR=2.40, P\u003c0.001), coronary heart disease (OR=2.66, P\u003c0.001), cerebrovascular diseases (OR=2.68, P=0.008), and malignancy (OR=2.21, P=0.040). We found significant differences between the two groups for fever, dyspnea, decreased lymphocyte and platelet counts, and increased leukocyte count, C-creative protein, procalcitonin, lactose dehydrogenase, aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and creatinine levels (P\u003c0.05). Significant differences were also observed for multiple treatments (P\u003c0.05). Patients in the severe (ICU) group were more likely to have complications and had a much higher mortality rate and lower discharge rate than those with non-severe (non-ICU) disease (P\u003c0.05). CONCLUSIONS: Investigation of clinical characteristics and outcomes of severe cases of COVID-19 will contribute to early prediction, accurate diagnosis, and treatment to improve the prognosis of patients with severe illness.