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?:abstract
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Mortality rates of coronavirus disease-2019 (COVID-19) continue to rise across the world Information regarding the predictors of mortality in patients with COVID-19 remains scarce Herein, we performed a systematic review of published articles, from 1 January to 24 April 2020, to evaluate the risk factors associated with mortality in COVID-19 Two investigators independently searched the articles and collected the data, in accordance with PRISMA guidelines We looked for associations between mortality and patient characteristics, comorbidities, and laboratory abnormalities A total of 14 studies documenting the outcomes of 4659 patients were included The presence of comorbidities such as hypertension (odds ratio [OR], 2 5;95% confidence interval [CI], 2 1-3 1;P < 00001), coronary heart disease (OR, 3 8;95% CI, 2 1-6 9;P < 00001), and diabetes (OR, 2 0;95% CI, 1 7-2 3;P < 00001) were associated with significantly higher risk of death amongst patients with COVID-19 Those who died, compared with those who survived, differed on multiple biomarkers on admission including elevated levels of cardiac troponin (+44 2 ng/L, 95% CI, 19 0-69 4;P = 0006);C-reactive protein (+66 3 g/mL, 95% CI, 46 7-85 9;P < 00001);interleukin-6 (+4 6 ng/mL, 95% CI, 3 6-5 6;P < 00001);D-dimer (+4 6 g/mL, 95% CI, 2 8-6 4;P < 00001);creatinine (+15 3 mol/L, 95% CI, 6 2-24 3;P = 001);and alanine transaminase (+5 7 U/L, 95% CI, 2 6-8 8;P = 0003);as well as decreased levels of albumin (-3 7 g/L, 95% CI, -5 3 to -2 1;P < 00001) Individuals with underlying cardiometabolic disease and that present with evidence for acute inflammation and end-organ damage are at higher risk of mortality due to COVID-19 infection and should be managed with greater intensity
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