Predictors of COVID-19 severity: a systematic review and meta-analysis [version 1; peer review: 2 approved]
Mudatsir Mudatsir,
Jonny Karunia Fajar,
Laksmi Wulandari,
Gatot Soegiarto,
Muhammad Ilmawan,
Yeni Purnamasari,
Bagus Aulia Mahdi,
Galih Dwi Jayanto,
Suhendra Suhendra,
Yennie Ayu Setianingsih,
Romi Hamdani,
Daniel Alexander Suseno,
Kartika Agustina,
Hamdan Yuwafi Naim,
Muchamad Muchlas,
Hamid Hunaif Dhofi Alluza,
Nikma Alfi Rosida,
Mayasari Mayasari,
Mustofa Mustofa,
Adam Hartono,
Richi Aditya,
Firman Prastiwi,
Fransiskus Xaverius Meku,
Monika Sitio,
Abdullah Azmy,
Anita Surya Santoso,
Radhitio Adi Nugroho,
Camoya Gersom,
Ali A. Rabaan,
Sri Masyeni,
Firzan Nainu,
Abram L. Wagner,
Kuldeep Dhama,
Harapan Harapan
Affiliations
Mudatsir Mudatsir
Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
Jonny Karunia Fajar
Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Laksmi Wulandari
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60286, Indonesia
Gatot Soegiarto
Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Easy Java, 60286, Indonesia
Muhammad Ilmawan
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Yeni Purnamasari
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Bagus Aulia Mahdi
Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Easy Java, 60286, Indonesia
Galih Dwi Jayanto
Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Suhendra Suhendra
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Yennie Ayu Setianingsih
Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60285, Indonesia
Romi Hamdani
Department of Orthopedic Surgery, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Daniel Alexander Suseno
Department of Obstetry and Gynecology, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Kartika Agustina
Department of Neurology, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Hamdan Yuwafi Naim
Department of Urology, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Muchamad Muchlas
Faculty of Animal Science, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Hamid Hunaif Dhofi Alluza
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Nikma Alfi Rosida
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Mayasari Mayasari
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Mustofa Mustofa
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Adam Hartono
Faculty of Medicine, Universitas Negeri Sebelas Maret, Surakarta, Surakarta, 57126, Indonesia
Richi Aditya
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Firman Prastiwi
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Fransiskus Xaverius Meku
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Monika Sitio
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Abdullah Azmy
Department of Orthopedic Surgery, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Anita Surya Santoso
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Radhitio Adi Nugroho
Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Camoya Gersom
Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
Background: The unpredictability of the progression of coronavirus disease 2019 (COVID-19) may be attributed to the low precision of the tools used to predict the prognosis of this disease. Objective: To identify the predictors associated with poor clinical outcomes in patients with COVID-19. Methods: Relevant articles from PubMed, Embase, Cochrane, and Web of Science were searched and extracted as of April 5, 2020. Data of interest were collected and evaluated for their compatibility for the meta-analysis. Cumulative calculations to determine the correlation and effect estimates were performed using the Z test. Results: In total, 19 papers recording 1,934 mild and 1,644 severe cases of COVID-19 were included. Based on the initial evaluation, 62 potential risk factors were identified for the meta-analysis. Several comorbidities, including chronic respiratory disease, cardiovascular disease, diabetes mellitus, and hypertension were observed more frequent among patients with severe COVID-19 than with the mild ones. Compared to the mild form, severe COVID-19 was associated with symptoms such as dyspnea, anorexia, fatigue, increased respiratory rate, and high systolic blood pressure. Lower levels of lymphocytes and hemoglobin; elevated levels of leukocytes, aspartate aminotransferase, alanine aminotransferase, blood creatinine, blood urea nitrogen, high-sensitivity troponin, creatine kinase, high-sensitivity C-reactive protein, interleukin 6, D-dimer, ferritin, lactate dehydrogenase, and procalcitonin; and a high erythrocyte sedimentation rate were also associated with severe COVID-19. Conclusion: More than 30 risk factors are associated with a higher risk of severe COVID-19. These may serve as useful baseline parameters in the development of prediction tools for COVID-19 prognosis.