Int J Med Sci 2020; 17(12):1744-1750. doi:10.7150/ijms.47052

Research Paper

Risk factors for the exacerbation of patients with 2019 Novel Coronavirus: A meta-analysis

Jinqiu Zhao1, Xiaosong Li2, Yao Gao1✉, Wenxiang Huang1✉

1. Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016.
2. Laboratory medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016.

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Citation:
Zhao J, Li X, Gao Y, Huang W. Risk factors for the exacerbation of patients with 2019 Novel Coronavirus: A meta-analysis. Int J Med Sci 2020; 17(12):1744-1750. doi:10.7150/ijms.47052. Available from http://www.medsci.org/v17p1744.htm

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Abstract

Many studies have reported the risk factors for exacerbations in patients with 2019 novel coronavirus (2019-nCoV). This study aims to perform the meta-analysis of risk factors for the exacerbation of the novel coronavirus-infected pneumonia (NCIP). PubMed, Embase and Google scholar have been searched. We included the cohort studies involving risk factors for the exacerbation of NCIP. This meta-analysis compared the risk factors of patients between intensive care (ICU) group and non-ICU group. Two cohort studies were included in this study. After comparing the patients between intensive care (ICU) group and non-ICU group, several important factors were found to significantly increase the risk of exacerbations in patients with NCIP, and they included hypertension (RR=2.34; 95% CI=1.21 to 4.51; P=0.01), cardiovascular diseases (RR=2.28; 95% CI=1.13 to 4.58; P=0.02), COPD (RR=7.65; 95% CI=1.24 to 47.13; P=0.03), dyspnea (RR=2.89; 95% CI=2.05 to 4.08; P<0.00001), myalgia or fatigue (RR=1.24; 95% CI=1.01 to 1.52; P=0.04), but several factors such as gender, Huanan Seafood Wholesale Market exposure, diabetes, chronic liver disease, malignancy, fever, cough, expectoration, headache and diarrhoea appeared to have no obvious effect on the exacerbation of pneumonia. In addition, as the exacerbation of pneumonia, some complications had the high probability to occur according to the meta-analysis of acute respiratory distress syndrome (ARDS) (RR=13.95; 95% CI=6.20 to 31.41; P<0.00001), shock (RR=24.29; 95% CI=4.66 to 126.69; P=0.0002), acute cardiac injury (RR=10.32; 95% CI=3.05 to 34.96; P=0.0002) and acute kidney injury (RR=5.90; 95% CI=1.32 to 26.35; P=0.02) between two groups. Several risk factors were confirmed to significantly improve the risk of exacerbation in patients with NCIP, which was very important for the exacerbation prediction and treatment of these patients.

Keywords: 2019 novel coronavirus, pneumonia, risk factor, exacerbation prediction, meta-analysis