Purpose Severe acute respiratory coronavirus 2 (SARS-CoV-2) cases are overgrowing globally and now become a pandemic. A meta-analysis was conducted to evaluate the impact of age, sex, comorbidities, and clinical characteristics on the severity of COVID-19 to help diagnose and evaluate the current outbreak in clinical decision-making. Methods PubMed, ScienceDirect, and BMC were searched to collect data about demographic, clinical characteristics, and comorbidities of COVID-19 patients. Meta-analysis was conducted with Review Manager 5.3. Publication bias was assessed using Egger’s test and Begg-Mazumdar’s rank correlation. Results Fifty-five studies were included in this meta-analysis, including 10014 patients with SARS-CoV-2 infection. Male cases and cases with an age of ≥50 years (OR = 2.41, p < 0.00001; RR = 3.36, p = 0.0002, respectively) were severely affected by SARS-CoV-2. Patients having age≥65 years are not associated (p = 0.110) with the severity of COVID-19. Presence of at least one comorbidity or hypertension, diabetes, cerebrovascular disease, cardiovascular diseases, respiratory disease, malignancy, chronic kidney disease and chronic liver diseases individually increased the severity of COVID-19 cases significantly (OR = 3.13, p < 0.00001; OR = 2.35, p < 0.00001; OR = 2.42, p < 0.00001; OR = 3.78, p < 0.00001; OR = 3.33, p < 0.00001; OR = 2.58, p < 0.00001; OR = 2.32, p < 0.00001; OR = 2.27, p = 0.0007; OR = 1.70, p = 0.003, respectively). Clinical manifestation such as fever, cough, fatigue, anorexia, dyspnea, chest tightness, hemoptysis, diarrhea and abdominal pain (OR = 1.68, p = 0.0001; OR = 1.41, p = 0.004; OR = 1.26, p = 0.03; OR = 2.38, p < 0.0001; OR = 4.30, p < 0.00001; OR = 2.11, p = 0.002; OR = 4.93, p < 0.0001; OR = 1.35, p = 0.03; OR = 2.38, p = 0.008, respectively) were significantly associated with the severity of cases. No association of severity was found with myalgia, pharyngalgia, nausea, vomiting, headache, dizziness and sore throat (p > 0.05). No publication bias was found in case of age (≥50 years, age≥65 years), comorbidities and clinical manifestations. Conclusions Males patients and elderly or older patients (age ≥50 years) are at higher risk of developing severity, whereas comorbidities and clinical manifestations could significantly affect the prognosis and severity of COVID-19. Microbiology; Virology; Viral disease; Travel medicine; Critical care; Health informatics; Covid-19; Pneumonia; Meta-analysis; Severe; Nonsevere; Risk factor; Comorbidity; Clinical manifestation
【저자키워드】 COVID-19, Meta-analysis, Microbiology, Virology, Critical care, Pneumonia, Comorbidity, risk factor, nonsevere, severe, health informatics, viral disease, clinical manifestation, Travel medicine, 【초록키워드】 SARS-CoV-2, review, pandemic, Prognosis, fatigue, Clinical characteristics, severity, Infection, Comorbidities, Sex, cardiovascular diseases, Chronic kidney disease, diabetes, cough, headache, abdominal pain, diarrhea, hypertension, clinical manifestations, older patient, outbreak, severity of COVID-19, Chest, Fever, Dyspnea, Respiratory disease, Patient, age, correlation, COVID-19 patients, diagnose, association, chronic liver disease, Cerebrovascular disease, Dizziness, myalgia, malignancy, sore throat, higher risk, anorexia, help, nausea, pharyngalgia, vomiting, Affect, hemoptysis, Respiratory Coronavirus, Result, affected, evaluate, significantly, conducted, searched, 1.26, Egger, patients with SARS-CoV-2, Presence, Publication bia, 【제목키워드】 Sex, severity of COVID-19, Impact, age, clinical symptom,