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

Vageesh Jain, Jin Min Yuan*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    95 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)533-546
    Number of pages14
    JournalInternational Journal of Public Health
    Volume65
    Issue number5
    DOIs
    Publication statusPublished - 1 Jun 2020

    Bibliographical note

    Publisher Copyright:
    © 2020, Swiss School of Public Health (SSPH+).

    Keywords

    • COVID-19
    • Disease severity
    • Epidemiology
    • Novel coronavirus
    • Public health
    • Risk factors

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