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Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis

Author

Listed:
  • Vageesh Jain

    (Public Health England
    University College London)

  • Jin-Min Yuan

    (Public Health, London Boroughs of Camden & Islington)

Abstract

Objectives COVID-19 has a varied clinical presentation. Elderly patients with comorbidities are more vulnerable to severe disease. This study identifies specific symptoms and comorbidities predicting severe COVID-19 and intensive care unit (ICU) admission. Methods A literature search identified studies indexed in MEDLINE, EMBASE and Global Health before 5th March 2020. Two reviewers independently screened the literature and extracted data. Quality appraisal was performed using STROBE criteria. Random effects meta-analysis identified symptoms and comorbidities associated with severe COVID-19 or ICU admission. Results Seven studies (including 1813 COVID-19 patients) were included. ICU patients were older (62.4 years) than non-ICU (46 years), with a greater proportion of males. Dyspnoea was the only symptom predictive for severe disease (pOR 3.70, 95% CI 1.83–7.46) and ICU admission (pOR 6.55, 95% CI 4.28–10.0). COPD was the strongest predictive comorbidity for severe disease (pOR 6.42, 95% CI 2.44–16.9) and ICU admission (pOR 17.8, 95% CI 6.56–48.2), followed by cardiovascular disease and hypertension. Conclusions Dyspnoea was the only symptom predictive for severe COVID-19 and ICU admission. Patients with COPD, cardiovascular disease and hypertension were at higher risk of severe illness and ICU admission.

Suggested Citation

  • Vageesh Jain & Jin-Min Yuan, 2020. "Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(5), pages 533-546, June.
    • Handle: RePEc:spr:ijphth:v:65:y:2020:i:5:d:10.1007_s00038-020-01390-7
    DOI: 10.1007/s00038-020-01390-7
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    Cited by:

    1. Pablo Ormeño & Gastón Márquez & Camilo Guerrero-Nancuante & Carla Taramasco, 2022. "Detection of COVID-19 Patients Using Machine Learning Techniques: A Nationwide Chilean Study," IJERPH, MDPI, vol. 19(13), pages 1-15, June.
    2. Michał Chojnicki & Agnieszka Neumann-Podczaska & Mikołaj Seostianin & Zofia Tomczak & Hamza Tariq & Jerzy Chudek & Sławomir Tobis & Iwona Mozer-Lisewska & Aleksandra Suwalska & Andrzej Tykarski & Piot, 2021. "Long-Term Survival of Older Patients Hospitalized for COVID-19. Do Clinical Characteristics upon Admission Matter?," IJERPH, MDPI, vol. 18(20), pages 1-16, October.
    3. Artem Kashtanov & Ekaterina Molotok & Andrey Yavorovskiy & Alexander Boyarkov & Yuriy Vasil’ev & Ali Alsaegh & Sergey Dydykin & Olesya Kytko & Renata Meylanova & Yulianna Enina & Vasiliy Troitskiy & M, 2022. "A Comparative Cross-Sectional Study Assessing the Psycho-Emotional State of Intensive Care Units’ Physicians and Nurses of COVID-19 Hospitals of a Russian Metropolis," IJERPH, MDPI, vol. 19(3), pages 1-22, February.
    4. Eliza Wasilewska & Agnieszka Sobierajska-Rek & Karolina Śledzińska & Sylwia Małgorzewicz & Ewa Jassem & Jolanta Wierzba, 2021. "Morbidity, Clinical Course and Vaccination against SARS-CoV-2 Virus in Patients with Duchenne Muscular Dystrophy: A Patient Reported Survey," IJERPH, MDPI, vol. 19(1), pages 1-10, December.
    5. Huilong Wang & Meimei Wang & Rong Yang & Huijuan Yang, 2023. "Urban Resilience of Important Node Cities in Population Migration under the Influence of COVID-19 Based on Mamdani Fuzzy Inference System," Sustainability, MDPI, vol. 15(19), pages 1-22, September.
    6. Rosa Magallón-Botaya & Bárbara Oliván-Blázquez & Karen Lizzette Ramírez-Cervantes & Fátima Méndez-López-de-la-Manzanara & Isabel Aguilar-Palacio & Marc Casajuana-Closas & Eva Andrés-Esteban, 2021. "Geographic Factors Associated with Poorer Outcomes in Patients Diagnosed with COVID-19 in Primary Health Care," IJERPH, MDPI, vol. 18(7), pages 1-11, April.
    7. Matthias Wolfgang Heinzl & Lisa Kolenchery & Michael Resl & Carmen Klammer & Anne Black & Florian Obendorf & Lukas Schinagl & Roland Feldbauer & Johannes Pohlhammer & Thomas Wagner & Thomas Berger & B, 2022. "High Anti-CoV2S Antibody Levels at Hospitalization Are Associated with Improved Survival in Patients with COVID-19 Vaccine Breakthrough Infection," IJERPH, MDPI, vol. 19(23), pages 1-9, November.
    8. Jennifer Nazareno & Emily Yoshioka & Alexander C Adia & Arjee Restar & Don Operario & Catherine Ceniza Choy, 2021. "From imperialism to inpatient care: Work differences of Filipino and White registered nurses in the United States and implications for COVID‐19 through an intersectional lens," Gender, Work and Organization, Wiley Blackwell, vol. 28(4), pages 1426-1446, July.

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