Mortality rates of coronavirus disease‐2019 (COVID‐19) continue to rise across the world. Information regarding the predictors of mortality in patients with COVID‐19 remains scarce. Herein, we performed a systematic review of published articles, from 1 January to 24 April 2020, to evaluate the risk factors associated with mortality in COVID‐19. Two investigators independently searched the articles and collected the data, in accordance with PRISMA guidelines. We looked for associations between mortality and patient characteristics, comorbidities, and laboratory abnormalities. A total of 14 studies documenting the outcomes of 4659 patients were included. The presence of comorbidities such as hypertension (odds ratio [OR], 2.5; 95% confidence interval [CI], 2.1‐3.1; P < .00001), coronary heart disease (OR, 3.8; 95% CI, 2.1‐6.9; P < .00001), and diabetes (OR, 2.0; 95% CI, 1.7‐2.3; P < .00001) were associated with significantly higher risk of death amongst patients with COVID‐19. Those who died, compared with those who survived, differed on multiple biomarkers on admission including elevated levels of cardiac troponin (+44.2 ng/L, 95% CI, 19.0‐69.4; P = .0006); C‐reactive protein (+66.3 µg/mL, 95% CI, 46.7‐85.9; P < .00001); interleukin‐6 (+4.6 ng/mL, 95% CI, 3.6‐5.6; P < .00001); D‐dimer (+4.6 µg/mL, 95% CI, 2.8‐6.4; P < .00001); creatinine (+15.3 µmol/L, 95% CI, 6.2‐24.3; P = .001); and alanine transaminase (+5.7 U/L, 95% CI, 2.6‐8.8; P = .0003); as well as decreased levels of albumin (−3.7 g/L, 95% CI, −5.3 to −2.1; P < .00001). Individuals with underlying cardiometabolic disease and that present with evidence for acute inflammation and end‐organ damage are at higher risk of mortality due to COVID‐19 infection and should be managed with greater intensity.

中文翻译：

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住院 COVID-19 患者死亡率的预测因素：系统评价和荟萃分析。


2019 年冠状病毒病 (COVID-19) 的死亡率在全球范围内持续上升。有关 COVID-19 患者死亡率预测因素的信息仍然很少。在此，我们对 2020 年 1 月 1 日至 4 月 24 日已发表的文章进行了系统回顾，以评估与 COVID-19 死亡率相关的风险因素。两名研究人员根据 PRISMA 指南独立检索文章并收集数据。我们寻找死亡率与患者特征、合并症和实验室异常之间的关联。总共纳入了 14 项研究，记录了 4659 名患者的结果。存在高血压等合并症（比值比 [OR]，2.5；95% 置信区间 [CI]，2.1-3.1； P < 0.00001）、冠心病（OR，3.8；95% CI，2.1-6.9； P < .00001）和糖尿病（OR，2.0；95% CI，1.7‐2.3； P < .00001）与 COVID-19 患者的死亡风险显着升高相关。与存活者相比，死亡者在入院时的多种生物标志物存在差异，包括心肌肌钙蛋白水平升高（+44.2 ng/L，95% CI，19.0‐69.4； P = .0006）； C 反应蛋白（+66.3 µg/mL，95% CI，46.7-85.9； P < .00001）；白细胞介素-6（+4.6 ng/mL，95% CI，3.6-5.6； P < .00001）； D-二聚体（+4.6 µg/mL，95% CI，2.8-6.4； P < .00001）；肌酐（+15.3 µmol/L，95% CI，6.2-24.3； P = .001）；和丙氨酸转氨酶（+5.7 U/L，95% CI，2.6-8.8； P = .0003）；以及白蛋白水平降低（-3.7 g/L，95% CI，-5.3 至 -2.1； P < .00001）。 患有潜在心脏代谢疾病且有急性炎症和终末器官损伤证据的个体因 COVID-19 感染而死亡的风险较高，应加大治疗强度。