{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:16:28Z","timestamp":1779113788809,"version":"3.51.4"},"reference-count":55,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T00:00:00Z","timestamp":1597190400000},"content-version":"unspecified","delay-in-days":224,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Our study aimed to systematically analyse the risk factors of coronavirus disease 2019 (COVID-19) patients with severe disease. An electronic search in eight databases to identify studies describing severe or critically ill COVID-19 patients from 1 January 2020 to 3 April 2020. In the end, we meta-analysed 40 studies involving 5872 COVID-19 patients. The average age was higher in severe COVID-19 patients (weighted mean difference; WMD = 10.69, 95%CI 7.83\u201313.54). Patients with severe disease showed significantly lower platelet count (WMD = \u221218.63, 95%CI \u221230.86 to \u22126.40) and lymphocyte count (WMD = \u22120.35, 95%CI \u22120.41 to \u22120.30) but higher C-reactive protein (CRP; WMD = 42.7, 95%CI 31.12\u201354.28), lactate dehydrogenase (LDH; WMD = 137.4, 95%CI 105.5\u2013169.3), white blood cell count\uff08WBC), procalcitonin\uff08PCT\uff09, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and creatinine\uff08Cr\uff09. Similarly, patients who died showed significantly higher WBC, D-dimer, ALT, AST and Cr but similar platelet count and LDH as patients who survived. These results indicate that older age, low platelet count, lymphopenia, elevated levels of LDH, ALT, AST, PCT, Cr and D-dimer are associated with severity of COVID-19 and thus could be used as early identification or even prediction of disease progression.<\/jats:p>","DOI":"10.1017\/s095026882000179x","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T03:20:06Z","timestamp":1597202406000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":116,"title":["Risk factors of severe cases with COVID-19: a meta-analysis"],"prefix":"10.1017","volume":"148","author":[{"given":"Mingchun","family":"Ou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7718-9591","authenticated-orcid":false,"given":"Jieyun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pan","family":"Ji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhimei","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bocheng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jielong","family":"Pang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianfeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaowen","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,8,12]]},"reference":[{"key":"S095026882000179X_ref55","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4683"},{"key":"S095026882000179X_ref53","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2020.03.001"},{"key":"S095026882000179X_ref50","first-page":"338","article-title":"Clinical characteristics of 55 hospitalized patients with COVID-19 in Wuhan, China","volume":"37","author":"Bin","year":"2020","journal-title":"Journal of Guangxi Medical University"},{"key":"S095026882000179X_ref49","first-page":"193","article-title":"Clinical analysis ofrisk factors for severe patients with novel coronavirus pneumonia","volume":"38","author":"Ling","year":"2020","journal-title":"Chinese Journal of Infectious Diseases"},{"key":"S095026882000179X_ref27","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000672"},{"key":"S095026882000179X_ref32","first-page":"117","article-title":"Clinical characteristics of 91 novel coronavirus pneumonia patients in Jiangmen First People's Hospital","volume":"42","author":"Chen","year":"2020","journal-title":"Journal of Inner Mongolia Medical University"},{"key":"S095026882000179X_ref18","first-page":"549","article-title":"The clinical features of the 143 patients with COVID-19 in North-East of Chongqing","volume":"42","author":"Xiao","year":"2020","journal-title":"Journal of Third Military Medical University"},{"key":"S095026882000179X_ref20","article-title":"Clinical characteristics of 223 novel coronavirus pneumonia cases in Chongqing","author":"Yuan","year":"2020","journal-title":"Journal of Southwest University (Natural Science Edition)"},{"key":"S095026882000179X_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"S095026882000179X_ref3","unstructured":"3. WHO. Coronavirus disease 2019 (COVID-19) Situation Dashboard. 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e175"}}