Critical Complications of COVID-19: A systematic Review and Meta-Analysis study

Background

Coronavirus disease 2019 (COVID-19) is a novel coronavirus infection that has spread worldwide in a short period and caused a pandemic. The goal of this meta-analysis is to evaluate the prevalence of most common symptoms and complications of COVID-19.

Methods

All related studies assessing the clinical complications of COVID-19 have been identified through web search databases (PubMed and Scopus). Relevant data were extracted from these studies and analyzed by stata (ver 14) random-effects model. The heterogeneity of studies were assessed byI²index. The publication bias was examined by Funnel plots and Egger’s test.

Results

30 studies were in our meta-analysis including 6 389 infected patients. The prevalence of most common symptoms were: fever 84.30% (95% CI: 77.13-90.37; I²=97.74%), cough 63.01% (95% CI: 57.63-68.23; I²=93.73%), dyspnea 37.16% (95% CI: 27.31-47.57%; I²=98.32%), fatigue 34.22% (95% CI: 26.29-42.62; I²=97.29%) and diarrhea 11.47 %(95% CI: 6.96-16.87; I²=95.58%), respectively. The most prevalent complications were acute respiratory distress syndrome (ARDS) 33.15% (95% CI: 23.35-43.73; I²=98.56%), acute cardiac injury 13.77% (95% CI: 9.66-18.45; I²=91.36%), arrhythmia 16.64% (95% CI: 9.34-25.5; I²=92.29%), heart failure 11.50% (95% CI: 3.45-22.83; I²=89.48%), and acute kidney injury (AKI) 8.40 %(95% CI: 5.15-12.31; I²=95.22%, respectively. According to our analysis, mortality rate of COVID-19 patients were 12.29% (95% CI: 6.20-19.99; I²=98.29%).

Conclusion

We assessed the prevalence of the main clinical complications of COVID-19 and found that after respiratory complications, cardiac and renal complications are the most common clinical complications of COVID-19.

Highlights

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  The most prevalent complication among critical cases of COVID-19 is ARDS.

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  After pulmonary complications, cardiovascular complications (like arrhythmia, heart failure and acute cardiac injury) are the most important threats for COVID-19 patients.

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  Renal complications (like AKI) happen as a result of COVID-19, but they are less prevalent than pulmonary and cardiovascular complications.