Evidence map›Paper›PMID 33141836›Full record

SynthesisPloS one2020

Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions.

Arthur Eumann Mesas, Iván Cavero-Redondo, Celia Álvarez-Bueno, Marcos Aparecido Sarriá Cabrera, Selma Maffei de Andrade, Irene Sequí-Dominguez, Vicente Martínez-Vizcaíno

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 157 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
157citing papers in PubMed, 17 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

157 citing papers in PubMed, 17 syntheses or guidelines pooled it.

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  5. The association between stroke and COVID-19-related mortality: a systematic review and meta-analysis based on adjusted effect estimates.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022
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  18. Inhaled ciclesonide for outpatient treatment of COVID-19 in adults at risk of adverse outcomes: a randomised controlled trial (COVERAGE).Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022
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  20. Characteristics and outcomes of adult patients hospitalised with RSV infection, influenza or COVID-19 in Belgium, winter seasons 2023/24 and 2024/25.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026
    Article

97 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Arthur Eumann MesasHealth and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain.
Iván Cavero-RedondoHealth and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain.ORCID 0000-0003-2617-0430
Celia Álvarez-BuenoHealth and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain.
Marcos Aparecido Sarriá CabreraPostgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
Selma Maffei de AndradePostgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
Irene Sequí-DominguezHealth and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain.
Vicente Martínez-VizcaínoHealth and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain.ORCID 0000-0001-6121-7893

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRisk factors for in-hospital mortality in confirmed COVID-19 patients have been summarized in numerous meta-analyses, but it is still unclear whether they vary according to the age, sex and health conditions of the studied populations. This study explored these variables as potential mortality predictors.

methodsA systematic review was conducted by searching the MEDLINE, Scopus, and Web of Science databases of studies available through July 27, 2020. The pooled risk was estimated with the odds ratio (p-OR) or effect size (p-ES) obtained through random-effects meta-analyses. Subgroup analyses and meta-regression were applied to explore differences by age, sex and health conditions. The MOOSE guidelines were strictly followed.

resultsThe meta-analysis included 60 studies, with a total of 51,225 patients (12,458 [24.3%] deaths) from hospitals in 13 countries. A higher in-hospital mortality risk was found for dyspnoea (p-OR = 2.5), smoking (p-OR = 1.6) and several comorbidities (p-OR range: 1.8 to 4.7) and laboratory parameters (p-ES range: 0.3 to -2.6). Age was the main source of heterogeneity, followed by sex and health condition. The following predictors were more markedly associated with mortality in studies with patients with a mean age ≤60 years: dyspnoea (p-OR = 4.3), smoking (p-OR = 2.8), kidney disease (p-OR = 3.8), hypertension (p-OR = 3.7), malignancy (p-OR = 3.7), diabetes (p-OR = 3.2), pulmonary disease (p-OR = 3.1), decreased platelet count (p-ES = -1.7), decreased haemoglobin concentration (p-ES = -0.6), increased creatinine (p-ES = 2.4), increased interleukin-6 (p-ES = 2.4) and increased cardiac troponin I (p-ES = 0.7). On the other hand, in addition to comorbidities, the most important mortality predictors in studies with older patients were albumin (p-ES = -3.1), total bilirubin (p-ES = 0.7), AST (p-ES = 1.8), ALT (p-ES = 0.4), urea nitrogen (p-ES), C-reactive protein (p-ES = 2.7), LDH (p-ES = 2.4) and ferritin (p-ES = 1.7). Obesity was associated with increased mortality only in studies with fewer chronic or critical patients (p-OR = 1.8).

conclusionThe prognostic effect of clinical conditions on COVID-19 mortality vary substantially according to the mean age of patients. PROSPERO REGISTRATION NUMBER: CRD42020176595.

Indexed as

Hospital MortalityAge FactorsCoronavirus InfectionsCOVID-19Health StatusHospitalizationHumansPandemicsPneumonia, ViralRisk FactorsSex Factors

Identifiers

PMID33141836
PMCPMC7608886

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.