Background
Methods
Data sources and study selection
Data extraction
Quality assessment and publication bias
Statistical analysis
Results
Study selection
Study characteristics
Study | Study period and location | Study design | Population, N | Male, N (%) | Median/mean age, year | Non-severe disease/severe disease, N | Non-ICU/ICU, N | Survivors/Non-survivors, N | Definition of severe disease | Study population | Quality score |
---|---|---|---|---|---|---|---|---|---|---|---|
Wang DW et al. [16] | Jan 1 to Jan 28, 2020, Wuhan, China | SC, retrospective case series | 138 | 75 (54.3) | 56 (IQR: 42–68) | NA | 102/36 | NA | Developed ARDS | Consecutive hospitalized patients with confirmed NCIP | 9 |
Wu CM et al. (a) [17] | Dec 25, 2019, to Jan 26, 2020, Wuhan, China | SC, retrospective cohort study | 201* | 128 (63.7) | 51 (IQR: 43–60) | 117/84 | NA | 40/44 | Developed ARDS | Patients with confirmed COVID-19 pneumonia | 9 |
Yang XB et al. [18] | Dec 24, 2019, to Jan 26, 2020, Wuhan, China | SC, retrospective, observational study | 52 | 35 (67.3) | 59.7 (SD: 13.3) | NA | NA | 20/32 | NA | Critically ill patients with SARS-CoV-2 pneumonia | 8 |
Huang CL et al. [2] | Dec 16, 2019, to Jan 2, 2020, Wuhan, China | NA, retrospective | 41 | 30 (73.2) | 49 (IQR: 41–58) | NA | 28/13 | 35/6 | Required high-flow nasal cannula or higher-level oxygen support measures to correct hypoxemia | Patients identified as having laboratory-confirmed 2019-nCoV infection and admitted hospital | 8 |
Chen D et al. [19] | Jan 11 to Feb 15, 2020, Wenzhou, China, | MC, retrospective study | 175 | 83 (47.4) | 46 (IQR: 34–54) | 40/135 | NA | NA | Showed pneumonia and any of acute respiratory distress syndrome | Patients with COVID-19 | 8 |
Fu L et al. [20] | Jan 1 to Jan 30,2020, Wuhan, China | SC, retrospective cohort study | 200 | 99 (49.5) | NA | NA | NA | 166/34 | NA | Patients with confirmed COVID-19 | 8 |
Guan WJ et al. [21] | Jan 1 to Jan 29,2020, China | MC, retrospective study | 1099 | 640 (58.2) | 47 (IQR: 35–58) | 926/173 | NA | 1084/15 | NA | Patients with laboratory-confirmed 2019-nCoV ARD | 8 |
Hui H et al. [22] | Jan 21 to Feb 03, 2020, Beijing, China | SC, retrospective study | 41 | 19 (46.3) | 47 (IQR: 35.5–64) | 34/7 | NA | NA | NA | Patients with confirmed COVID-19 | 7 |
Liu YL et al. [23] | Jan 2 to Feb 12, 2020, Wuhan, China | SC, retrospective study | 109 | 59 (54.1) | 55 (IQR: 43–66) | 56/53 | NA | 78/31 | Developed ARDS | Patients with confirmed COVID-19 | 8 |
Liu L et al. [24] | Jan 20 to Feb 3, 2020, Chongqing, China | SC, retrospective case series | 51 | 32 (62.7) | 45 (IQR: 34–51) | 44/7 | NA | NA | NA | Patients with confirmed COVID-19 | 8 |
Qi D et al. [25] | Jan 19 to Feb 16, 2020, Chongqing, China | MC, retrospective, descriptive study | 267 | 149 (55.8) | 48 (IQR: 35–65) | 217/50 | 214/53 | 263/4 | According to the American Thoracic Society guideline | Patients with COVID-19 confirmed by real-time RT-PCR | 7 |
Wang YF et al. [26] | Jan 1 to Feb 10, 2020, Wuhan, China | SC, retrospective | 110 | 48 (43.6) | NA | 72/38 | NA | NA | Fever or suspected respiratory infection, plus one of a respiratory rate > 30 breaths/min, severe respiratory distress, or SpO2 < 90% on room air | Patients with confirmed COVID-19 pneumonia | 8 |
Wu CM et al. (b) [27] | Dec 25, 2019 to Jan 27, 2020, Wuhan, China | SC, retrospective cohort study | 188 | 119 (63.3) | 51.9 (SD: 14.26) | NA | 138/50 | 145/4 | NA | Patients with confirmed COVID-19 pneumonia | 8 |
Xu HY et al. [28] | Jan 02 to Feb 14, 2020, NA | NA, retrospective | 53 | 28 (52.8) | NA | 34/19 | 45/8 | 53/3 | More likely to have underlying comorbidities, and AMI | Consecutive laboratory-confirmed and hospitalized patients with confirmed NCIP | 7 |
Xu YH et al. [29] | Jan 14 to Feb 28, 2020, Guangdong, China | MC, retrospective, observational study | 45 | 29 (64.4) | 56.7 (SD: 15.4) | 25/20 | 0/45 | 44/1 | Defined as those required oxygen therapy, symptoms of respiratory distress or required mechanical ventilation | critically ill patients with SARS-CoV-2 pneumonia RT-PCR confirmed positive patients | 8 |
Liu YB et al. [30] | Jan 10 to Feb 24, 2020, Guangzhou, China | SC, retrospective | 291 | 133 (45.7) | 48.1 (IQR: 34–62) | 262/29 | 265/26 | 290/1 | NA | Laboratory-confirmed patients with NCIP | 8 |
Peng YD et al. [31] | Jan 20 to Feb, 15, 2020, Wuhan, China | SC, retrospective, cohort study | 112 | 53 (47.0) | 62 (IQR: 55–67) | 96/16 | NA | 84/28 | Required mechanical ventilation; shock; combined with other organ failure | COVID-19 patients with CVD | 7 |
Zhang GQ et al. [32] | Jan 2 to Feb, 10, 2020, Wuhan, China | SC, retrospective case series study | 221 | 108 (48.9) | 55 (IQR: 39–66.5) | 166/55 | NA | 209/12 | Fever plus one of these conditions, including respiratory rate ≥ 30 breaths/min, severe respiratory distress, SpO2 ≤ 93% on room air, occurrence of respiratory failure requiring mechanical ventilation, shock and other organ failure | Patients who were confirmed diagnosed as COVID-19 according to WHO interim guidance | 8 |
Liu T et al. [33] | Jan 21, to Feb 16, 2020, Wuhan, China | NA, retrospective | 80 | 34 (42.5) | 53 (range: 26–86) | 11/69 | NA | 80/0 | Defined when any of the following criteria was met: dyspnea, respiration rate ≥ 30 times/min; oxygen saturation by pulse oximeter ≤93% in resting state; partial pressure of arterial oxygen to fraction of inspired oxygen ratio ≤ 300 mmHg | SARS-CoV-2 nucleic acid or RT-PCR confirmed positive patients | 8 |
Shi SB et al. [4] | Jan 20, to Feb 10, 2020, Wuhan, China | SC, retrospective cohort study | 416 | 205 (49.3) | 64 (range: 21–95) | 319/97 | NA | 359/57 | NA | Consecutive inpatients with laboratory-confirmed COVID-19 | 9 |
Wu J et al. [34] | Jan 20 to Feb 20,2020, Jiangsu and Anhui Province, China | MC, retrospective case series | 280 | 151 (53.9) | 43.1 (SD:19.02) | 197/83 | NA | NA | NA | Patients infected with SARS-CoV-2 | 8 |
Chen T et al. [35] | Jan 13, to Feb 28, 2020, Wuhan, China | SC, retrospective | 274 | 171 (62) | 62 (IQR: 44–70) | NA | NA | 161/113 | NA | Patients with confirmed COVID-19 pneumonia | 8 |
Guo T et al. [36] | Jan 23, to Feb 23, 2020, Wuhan, China | SC, retrospective | 187 | 91 (48.7) | 58.5 (SD:14.66) | NA | NA | 144/43 | NA | Patients with confirmed COVID-19 pneumonia | 9 |
Source | Severe disease/ARDS | ICU | Death | NT-proBNP, Median (IQR), pg/mL | Definition of cardiac injury | ||||
---|---|---|---|---|---|---|---|---|---|
Elevated TnI/TnT, N/total | Non-elevated TnI/TnT, N/total | Elevated TnI/TnT, N/total | Non-elevated TnI/TnT, N/total | Elevated TnI/TnT, N/total | Non-elevated TnI/TnT, N/total | Elevated TnI/TnT | Non-elevated TnI/TnT | ||
Liu et al. [30] | 11/15 | 18/276 | 11/15 | 15/276 | 1/15 | 0/276 | NA | NA | TnI > 0.03 μg/L |
Xu et al. [28] | 6/6 | 13/47 | 6/6 | 2/47 | 3/6 | 0/47 | NA | NA | TnT-HSST > 28 pg/ml |
Wu et al. (b) [27] | NA | NA | 27/62 | 23/126 | 31/62 | 12/126 | NA | NA | Hs-TnI ≥ 6.126 pg/mL |
Hui et al. [22] | 4/4 | 1/16 | NA | NA | NA | NA | NA | NA | NA |
Wang et al. [16] | NA | NA | 8/10 | 28/128 | NA | NA | NA | NA | NA |
Yang et al. [18] | NA | NA | NA | NA | 9/12 | 23/40 | NA | NA | Hs-TNI > 28 pg/mL |
Shi et al. [4] | 48/82 | 49/334 | NA | NA | 42/82 | 15/334 | 1689 (698–3327) | 139 (51–335) | Hs-TnI > 0.04 ng/mL |
Chen et al. [35] | NA | NA | NA | NA | 68/83 | 26/120 | NA | NA | Hs-TnI > 15.6 pg/mL |
Guo et al. [36] | NA | NA | NA | NA | 31/52 | 12/135 | 817.4 (336.0–1944.0) | 141.4 (39.3–303.6) | Elevated TnT levels |
Characteristic | Non-elevated TnI/TnT vs. elevated TnI/TnT | Non-severe disease/non-ICU vs. severe disease/ICU | Survivors vs. non-survivors | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
I2(%) | RR | 95%CI | Z | P | I2(%) | RR/SMD | 95%CI | Z | P | I2(%) | RR/SMD | 95%CI | Z | P | |
Severe, n | 78.6 | 5.57 | (3.04, 10.22) | 5.55 | 0.00 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
ICU, n | 89.3 | 6.20 | (2.52, 15.29) | 3.96 | 0.00 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Death, n | 89.1 | 5.64 | (2.69, 11.83) | 4.57 | 0.00 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
NT-proBNP (pg/ml) | 86.6 | 1.63 | (1.02, 2.23) | 5.27 | 0.00 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Elevated TnI/TnT, n | NA | NA | NA | NA | NA | 83.7 | 15.10 | (4.10, 55.61) | 4.08 | 0.00 | 22.5 | 4.69 | (3.39, 6.48) | 9.37 | 0.00 |
TnI (pg/ml) | NA | NA | NA | NA | NA | 84.6 | 0.74 | (0.19, 1.30) | 2.62 | 0.009 | NA | NA | NA | NA | NA |
Elevated CK, n | NA | NA | NA | NA | NA | 0.0 | 1.98 | (1.50, 2.61) | 4.78 | 0.00 | NA | NA | NA | NA | NA |
CK (U/L) | NA | NA | NA | NA | NA | 69.0 | 0.39 | (0.11, 0.67) | 2.76 | 0.006 | NA | NA | NA | NA | NA |
Elevated CK-MB, n | NA | NA | NA | NA | NA | 79.8 | 3.24 | (1.66, 6.34) | 3.44 | 0.001 | NA | NA | NA | NA | NA |
CK-MB (U/L) | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Elevated LDH, n | NA | NA | NA | NA | NA | 79.7 | 2.20 | (1.55, 3.12) | 4.40 | 0.00 | NA | NA | NA | NA | NA |
LDH (U/L) | NA | NA | NA | NA | NA | 92.7 | 1.15 | (0.61, 1.70) | 4.16 | 0.00 | 98.6 | 2.86 | (0.67, 5.06) | 2.56 | 0.01 |
BNP (pg/ml) | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Arrhythmia, n | NA | NA | NA | NA | NA | 42.0 | 13.09 | (7.00, 24.47) | 8.06 | 0.00 | NA | NA | NA | NA | NA |
IL-6 (pg/ml) | NA | NA | NA | NA | NA | 0.0 | 0.54 | (0.27, 0.81) | 3.94 | 0.00 | 13.7 | 1.28 | (1.00, 1.57) | 8.85 | 0.00 |