COVID-19 Clinical Characteristics, and Sex-Specific Risk of Mortality: Systematic Review and Meta-Analysis

Mohammad Javad Nasiri; Sara Haddadi; Azin Tahvildari; Yeganeh Farsi; Mahta Arbabi; Saba Hasanzadeh; Parnian Jamshidi; Mukunthan Murthi; Mehdi Mirsaeidi

doi:10.3389/fmed.2020.00459

COVID-19 Clinical Characteristics, and Sex-Specific Risk of Mortality: Systematic Review and Meta-Analysis

Front Med (Lausanne). 2020 Jul 21:7:459. doi: 10.3389/fmed.2020.00459. eCollection 2020.

Authors

Mohammad Javad Nasiri¹, Sara Haddadi², Azin Tahvildari³, Yeganeh Farsi³, Mahta Arbabi³, Saba Hasanzadeh³, Parnian Jamshidi³, Mukunthan Murthi², Mehdi Mirsaeidi^{2

4}

Affiliations

¹ Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Division of Pulmonary and Critical Care, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States.
³ Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Pulmonary and Critical Care, Miami VA Medical Center, Miami, FL, United States.

Abstract

Background: The rapidly evolving coronavirus disease 2019 (COVID-19), was declared a pandemic by the World Health Organization on March 11, 2020. It was first detected in the Wuhan city of China and has spread globally resulting in a substantial health and economic crisis in many countries. Observational studies have partially identified different aspects of this disease. There have been no published systematic reviews that combine clinical, laboratory, epidemiologic, and mortality findings. Also, the effect of gender on the outcomes of COVID-19 has not been well-defined. Methods: We reviewed the scientific literature published from January 1, 2019 to May 29, 2020. Statistical analyses were performed with STATA (version 14, IC; Stata Corporation, College Station, TX, USA). The pooled frequency with 95% confidence intervals (CI) was assessed using random effect model. P < 0.05 was considered a statistically significant publication bias. Results: Out of 1,223 studies, 34 satisfied the inclusion criteria. A total of 5,057 patients with a mean age of 49 years were evaluated. Fever (83.0%, CI 77.5-87.6) and cough (65.2%, CI 58.6-71.2) were the most common symptoms. The most prevalent comorbidities were hypertension (18.5%, CI 12.7-24.4) and Cardiovascular disease (14.9%, CI 6.0-23.8). Among the laboratory abnormalities, elevated C-Reactive Protein (CRP) (72.0%, CI 54.3-84.6) and lymphopenia (50.1%, CI 38.0-62.4) were the most common. Bilateral ground-glass opacities (66.0%, CI 51.1-78.0) was the most common CT scan presentation. The pooled mortality rate was 6.6%, with males having significantly higher mortality compared to females (OR 3.4; 95% CI 1.2-9.1, P = 0.01). Conclusion: COVID-19 has caused a significant number of hospitalization and mortality worldwide. Mortality associated with COVID-19 was higher in our study compared to the previous reports from China. The mortality was significantly higher among the hospitalized male group. Further studies are required to evaluate the effect of different variables resulting in sex disparity in COVID-19 mortality.

Keywords: COVID-19; coronavirus; male; mortality; pandemic.

Publication types

Systematic Review