Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis

17, November 2020 | Bangladesh

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Abstract

The main aim of this study was to fnd the prevalence of mortality among hospitalized COVID-19 infected patients and associated risk factors for death. Methods Three electronic databases including PubMed, Science Direct and Google Scholar were searched to identify rel- evant cohort studies of COVID-19 disease from January 1, 2020, to August 11, 2020. A random-efects model was used to calculate pooled prevalence rate (PR), risk ratio (RR) and 95% confdence interval (CI) for both efect measures. Cochrane chi-square test statistic Q, I2, and τ2 tests were used to measure the presence of heterogeneity. Publication bias and sensitivity of the included studies were also tested. Results In this meta-analysis, a total of 58 studies with 122,191 patients were analyzed. The pooled prevalence rate of mortal- ity among the hospitalized COVID-19 patients was 18.88%, 95% CI (16.46–21.30), p<0.001. Highest mortality was found in Europe [PR 26.85%, 95% CI (19.41–34.29), p<0.001] followed by North America [PR 21.47%, 95% CI (16.27–26.68), p<0.001] and Asia [PR 14.83%, 95% CI (12.46- 17.21), p<0.001]. An signifcant association were found between mortal- ity among COVID-19 infected patients and older age (>65 years vs.<65 years) [RR 3.59, 95% CI (1.87–6.90), p<0.001], gender (male vs. female) [RR 1.63, 95% CI (1.43–1.87), p<0.001], ICU admitted patients [RR 3.72, 95% CI (2.70–5.13), p<0.001], obesity [RR 2.18, 95% CI (1.10–4.34), p<0.05], hypertension [RR 2.08,95% CI (1.79–2.43) p<0.001], diabe- tes [RR 1.87, 95% CI (1.23–2.84), p<0.001], cardiovascular disease [RR 2.51, 95% CI (1.20–5.26), p<0.05], and cancer [RR 2.31, 95% CI (1.80–2.97), p<0.001]. In addition, signifcant association for high risk of mortality were also found for cerebrovascular disease, COPD, coronary heart disease, chronic renal disease, chronic liver disease, chronic lung disease and chronic kidney disease. Conclusion This meta-analysis revealed that the mortality rate among COVID-19 patients was highest in the European region and older age, gender, ICU patients, patients with comorbidity had a high risk for case fatality. Those fndings would help the health care providers to reduce the mortality rate and combat this pandemic to save lives using limited resources.