Potential risk factors for case fatality rate of novel coronavirus (COVID-19) in China: A pooled analysis of individual patient data

Am J Emerg Med. 2020 Nov;38(11):2374-2380. doi: 10.1016/j.ajem.2020.08.039. Epub 2020 Aug 17.

Abstract

Background and objective: Since the first case of the pneumonia caused by 2019 novel coronavirus (COVID-19) is found in Wuhan, there have been more than 70,000 cases reported in China. This study aims to perform the meta-analysis of risk factors for the case fatality rate (CFR) of the 2019 novel coronavirus (COVID-19).

Design and methods: We have searched PubMed, Google scholar and medRxiv for the cohort studies involving risk factors for the CFR of COVID-19. This meta-analysis compares the risk factors of CFR between fatal patients and non-fatal patients.

Results: Two cohort studies are included in this study. After comparing the patients between fatal cases and non-fatal cases, several important factors are found to significantly increase the CFR in patients with COVID-19, and include the age ranging 60-70 (OR = 1.85; 95% CI = 1.62 to 2.11; P < .00001) and especially≥70 (OR = 8.45; 95% CI = 7.47 to 9.55; P < .00001), sex of male (OR = 1.88; 95% CI = 1.30 to 2.73; P = .0008), occupation of retirees (OR = 4.27; 95% CI = 2.50 to 7.28; P < .00001), and severe cases (OR = 691.76; 95% CI = 4.82 to 99,265.63; P = .01). As the advancement of early diagnosis and treatment, the CFR after January 21 (or 22), 2020 is substantially decreased in COVID-19 than before (OR = 0.21; 95% CI = 0.19 to 0.24; P < .00001).

Conclusions: Several factors are confirmed to significantly improve the CFR in patients with COVID-19, which is very important for the treatment and good prognosis of these patients.

Keywords: 2019 novel coronavirus (COVID-19); CFR; Meta-analysis; Risk factor.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • COVID-19 / mortality*
  • China / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupations
  • Pandemics
  • Risk Factors*
  • Sex Factors