{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:32:07Z","timestamp":1791322327779,"version":"4.3.1"},"reference-count":121,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T00:00:00Z","timestamp":1607299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K01AI148583"],"award-info":[{"award-number":["K01AI148583"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UNOPS STOP TB PARTNERSHIP TB REACH","award":["STBP\/TBREACH\/GSA\/W7-7692"],"award-info":[{"award-number":["STBP\/TBREACH\/GSA\/W7-7692"]}]},{"name":"Johns Hopkins Alliance for a Healthier World","award":["80045453"],"award-info":[{"award-number":["80045453"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Progression of COVID-19 to severe disease and death is insufficiently understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Summarize the prevalence of risk factors and adverse outcomes and determine their associations in COVID-19 patients who were hospitalized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched Medline, Embase and Web of Science for case-series and observational studies of hospitalized COVID-19 patients through August 31, 2020. Data were analyzed by fixed-effects meta-analysis using Shore\u2019s adjusted confidence intervals to address heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-seven studies comprising 38906 hospitalized patients met inclusion criteria; 21468 from the US-Europe and 9740 from China. Overall prevalence of death [% (95% CI)] from COVID-19 was 20% (18\u201323%); 23% (19\u201327%) in the US and Europe and 11% (7\u201316%) for China. Of those that died, 85% were aged\u226560 years, 66% were males, and 66%, 44%, 39%, 37%, and 27% had hypertension, smoking history, diabetes, heart disease, and chronic kidney disease (CKD), respectively. The case fatality risk [%(95% CI)] were 52% (46\u201360) for heart disease, 51% (43\u201359) for COPD, 48% (37\u201363) for chronic kidney disease (CKD), 39% for chronic liver disease (CLD), 28% (23\u201336%) for hypertension, and 24% (17\u201333%) for diabetes. Summary relative risk (sRR) of death were higher for age\u226560 years [sRR = 3.6; 95% CI: 3.0\u20134.4], males [1.3; 1.2\u20131.4], smoking history [1.3; 1.1\u20131.6], COPD [1.7; 1.4\u20132.0], hypertension [1.8; 1.6\u20132.0], diabetes [1.5; 1.4\u20131.7], heart disease [2.1; 1.8\u20132.4], CKD [2.5; 2.1\u20133.0]. The prevalence of hypertension (55%), diabetes (33%), smoking history (23%) and heart disease (17%) among the COVID-19 hospitalized patients in the US were substantially higher than that of the general US population, suggesting increased susceptibility to infection or disease progression for the individuals with comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Public health screening for COVID-19 can be prioritized based on risk-groups. Appropriately addressing the modifiable risk factors such as smoking, hypertension, and diabetes could reduce morbidity and mortality due to COVID-19; public messaging can be accordingly adapted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0243191","type":"journal-article","created":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T16:15:18Z","timestamp":1607357718000},"page":"e0243191","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":191,"title":["Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0992-0631","authenticated-orcid":true,"given":"Kunchok","family":"Dorjee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunju","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-6127","authenticated-orcid":true,"given":"Elizabeth","family":"Bonomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinchen","family":"Dolma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,7]]},"reference":[{"key":"pone.0243191.ref001","unstructured":"Johns Hopkins University. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). https:\/\/coronavirus.jhu.edu\/map.html. Published 2020. Accessed October 8, 2020."},{"issue":"15","key":"pone.0243191.ref002","doi-asserted-by":"crossref","first-page":"458","DOI":"10.15585\/mmwr.mm6915e3","article-title":"Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019\u2014COVID-NET, 14 States, March 1\u201330, 2020","volume":"69","author":"S Garg","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0243191.ref003","article-title":"Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention","author":"Z Wu","year":"2020","journal-title":"JAMA"},{"issue":"10239","key":"pone.0243191.ref004","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1016\/S0140-6736(20)31189-2","article-title":"Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study","volume":"395","author":"MJ Cummings","year":"2020","journal-title":"Lancet"},{"issue":"5","key":"pone.0243191.ref005","article-title":"Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study","volume":"55","author":"RH Du","year":"2020","journal-title":"Eur Respir J"},{"issue":"1","key":"pone.0243191.ref006","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jaci.2020.04.006","article-title":"Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan","volume":"146","author":"X Li","year":"2020","journal-title":"J Allergy Clin Immunol"},{"key":"pone.0243191.ref007","first-page":"154262","article-title":"Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx","volume":"108","author":"L Palaiodimos","year":"2020","journal-title":"New York. 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