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The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

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  • Ning Zhang

    (School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
    Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an 710049, China
    Department of Infectious Disease Epidemiology, Centre for Global Infectious Disease Analysis, Imperial College London, London SW7 2AZ, UK)

  • Tao Xie

    (School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
    Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an 710049, China)

  • Wei Ning

    (School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
    Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an 710049, China)

  • Rongxin He

    (School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
    Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an 710049, China)

  • Bin Zhu

    (School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China)

  • Ying Mao

    (School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
    Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an 710049, China)

Abstract

To analyse the prevalence of severe and critical COVID-19 cases and its determinants, a systematic review and meta-analysis were conducted using Review Manager. Four English and two Chinese databases were used to identify and explore the relationships between the severity of COVID-19 and its determinants, with no restrictions on publication date. The odds ratio and 95% CI were combined to assess the influencing level of all factors. Twenty-three articles containing a total of 15,828 cases of COVID-19 were included in this systematic review. The prevalence of severe and critical COVID-19 cases was 17.84% and 4.9%, respectively. A total of 148 factors were identified, which included behavioural, symptom, comorbidity, laboratory, radiographic, exposure, and other factors. Among them, 35 factors could be included in the meta-analysis. Specifically, for example, the male (OR 1.55, 95% CI 1.42–1.69) and elderly (OR 1.06, 95% CI 1.03–1.10) populations tended to experience severe and critical illness. Patients with cough, dyspnea, fatigue, fever, and gastrointestinal symptoms could have severe and critical diseases. Regarding laboratory results, albumin, aspartate aminotransferase, creatinine, D-dimer, fibrinogen, neutrophils, procalcitonin, platelets, and respiratory rate were potential factors that could be used to predict the severity of COVID.

Suggested Citation

  • Ning Zhang & Tao Xie & Wei Ning & Rongxin He & Bin Zhu & Ying Mao, 2021. "The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China," Sustainability, MDPI, vol. 13(9), pages 1-17, May.
    • Handle: RePEc:gam:jsusta:v:13:y:2021:i:9:p:5305-:d:551386
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