SynthesisPloS one2021
Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis.
Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
112 citing papers in PubMed, 6 syntheses or guidelines pooled it, 251 citations in OpenAlex.
- Asthma and COPD as co-morbidities in patients hospitalised with Covid-19 disease: a global systematic review and meta-analysis.BMC pulmonary medicine · 2023Pooled it
- Effect of exercise intervention on smoking cessation: a meta-analysis.Frontiers in physiology · 2023Pooled it
- Prevalence of hypertension and associated risks in hospitalized patients with COVID-19: a meta-analysis of meta-analyses with 1468 studies and 1,281,510 patients.Systematic reviews · 2022Pooled it
- ABO blood group and risk of COVID-19 infection and complications: A systematic review and meta-analysis.Transfusion · 2022Pooled it
- COVID-19 Prevalence among Healthcare Workers. A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- Thyroid disease and hypothyroidism are associated with poor COVID-19 outcomes: A systematic review, meta-analysis, and meta-regression.Diabetes & metabolic syndromePooled it
- Epidemiological pattern of death and causes of death in registered immigrants of Northeast Iran during the 2013-2023: a cross-sectional study.BMC public health · 2026Article
- A Quarter-Century of Chronic Obstructive Pulmonary Disease in the Intensive Care Unit (2000-2025): A Bibliometric Roadmap of Thematic Evolution and Future Frontiers.International journal of chronic obstructive pulmonary disease · 2026Review
- Clinical Characteristics of Adenovirus Pneumonia in Children.Pathogens (Basel, Switzerland) · 2025Article
- Post-COVID-19 Dysphonia: Risk, Voice Handicap, and Laryngological Findings in COVID-19 Critical Illness Survivors.International archives of otorhinolaryngology · 2025Article
- Recurrent waning of anti-SARS-CoV-2 neutralizing antibodies despite multiple antigen encounters.Journal of translational medicine · 2025Article
- Effectiveness of Dexamethasone for COVID-19 in Hospitalized Patients With Diabetes: A Retrospective Cohort Study.The Journal of clinical endocrinology and metabolism · 2025Article
- Seasonal synchronization and unpredictability in epidemic models with waning immunity and healthcare thresholds.Scientific reports · 2025Article
- Efficient and scalable construction of clinical variable networks for complex diseases with RAMEN.Cell reports methods · 2025Article
- Prognostic Factors and Clinical Prediction Score for Progressive Respiratory Failure in Severe COVID-19 Pneumonia Patients Treated with Tocilizumab: A Multicenter Study.Therapeutics and clinical risk management · 2025Article
- Elevated non-invasive liver fibrosis scores at admission are independent risk factors for severe COVID-19: a retrospective cohort study from 2020 to 2024.Frontiers in medicine · 2025Article
- Health diagnosis associated with COVID-19 death in the United States: A retrospective cohort study using electronic health records.PloS one · 2025Article
- From test to rest: evaluating socioeconomic differences along the COVID-19 care pathway in the Netherlands.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Observational
- Delphi Panel Consensus Statement Generation: COVID-19 Vaccination Recommendations for Immunocompromised Populations in the European Union.Infectious diseases and therapy · 2024Article
- Article
52 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe aimed to systematically identify the possible risk factors responsible for severe cases.
methodsWe searched PubMed, Embase, Web of science and Cochrane Library for epidemiological studies of confirmed COVID-19, which include information about clinical characteristics and severity of patients' disease. We analyzed the potential associations between clinical characteristics and severe cases.
resultsWe identified a total of 41 eligible studies including 21060 patients with COVID-19. Severe cases were potentially associated with advanced age (Standard Mean Difference (SMD) = 1.73, 95% CI: 1.34-2.12), male gender (Odds Ratio (OR) = 1.51, 95% CI:1.33-1.71), obesity (OR = 1.89, 95% CI: 1.44-2.46), history of smoking (OR = 1.40, 95% CI:1.06-1.85), hypertension (OR = 2.42, 95% CI: 2.03-2.88), diabetes (OR = 2.40, 95% CI: 1.98-2.91), coronary heart disease (OR: 2.87, 95% CI: 2.22-3.71), chronic kidney disease (CKD) (OR = 2.97, 95% CI: 1.63-5.41), cerebrovascular disease (OR = 2.47, 95% CI: 1.54-3.97), chronic obstructive pulmonary disease (COPD) (OR = 2.88, 95% CI: 1.89-4.38), malignancy (OR = 2.60, 95% CI: 2.00-3.40), and chronic liver disease (OR = 1.51, 95% CI: 1.06-2.17). Acute respiratory distress syndrome (ARDS) (OR = 39.59, 95% CI: 19.99-78.41), shock (OR = 21.50, 95% CI: 10.49-44.06) and acute kidney injury (AKI) (OR = 8.84, 95% CI: 4.34-18.00) were most likely to prevent recovery. In summary, patients with severe conditions had a higher rate of comorbidities and complications than patients with non-severe conditions.
conclusionPatients who were male, with advanced age, obesity, a history of smoking, hypertension, diabetes, malignancy, coronary heart disease, hypertension, chronic liver disease, COPD, or CKD are more likely to develop severe COVID-19 symptoms. ARDS, shock and AKI were thought to be the main hinderances to recovery.
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Registered trials
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 Socratic graph.