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Review
. 2023 Jan:51:101079.
doi: 10.1016/j.nmni.2022.101079. Epub 2023 Jan 4.

The global case fatality rate due to COVID-19 in hospitalized elderly patients by sex, year, gross domestic product, and continent: A systematic review, meta-analysis, and meta-regression

Elham Davtalab Esmaeili  1   2 , Hosein Azizi  3   4 , Ehsan Sarbazi  2 , Farzad Khodamoradi  5
Affiliations
Review

The global case fatality rate due to COVID-19 in hospitalized elderly patients by sex, year, gross domestic product, and continent: A systematic review, meta-analysis, and meta-regression

Elham Davtalab Esmaeili et al. New Microbes New Infect. 2023 Jan.

Abstract

Background: Although elderly people are at a huge risk of mortality due to COVID-19, the Case Fatality Rate (CFR) in hospitalized elderly patients is poorly investigated. This meta-analysis and meta-regression aimed to generate pooled CFR due to COVID-19 in hospitalized elderly patients by sex, Gross Domestic Product (GDP), year, and continent and also to explain the potential source of the heterogeneity and variations in the pooled estimation of COVID-19 CFR.

Methods: We systematically searched PubMed, Scopus, Web of Science, CINAHL, and Embase up to 31 July 2022. Eligibility assessment of records was performed independently in a blinded, standardized way by two reviewers. Meta-analysis and Meta-regression analysis were carried out to estimate pooled CFR and the potential sources of the heterogeneity.

Results: The study included 5683 confirmed hospitalized elderly COVID-19 patients, 1809 deaths, and 19 original articles from 10 countries. The pooled estimate of the overall CFR, and by male and female sexes were 29%, 34%, and 24%, respectively. We found CFR was decreased by increasing female sex proportion, GDP, and year of publication. Multivariate meta-regression analysis indicated that the age and sex of patients, continent, GDP, and year of the publication together explained the majority of the heterogeneity and variations in the pooled estimate of the hospitalized elderly COVID-19 CFR.

Conclusions: This review provided reliable pooled CFR measures for hospitalized elderly patients with COVID-19. Although COVID-19 fatality has decreased in hospitalized elderly patients over time, it is still high in hospitalized elderly patients and needs advanced treatment support.

Keywords: COVID-19; Elderly; Hospitalized; Meta-analysis; Mortality.

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Conflict of interest statement

The authors declare no competing interests regarding this study and its publication.

Figures

Fig. 1
Fig. 1
Search results and study selection and inclusion process.
Fig. 2
Fig. 2
Sub-group meta-analysis proportion of hospitalized elderly COVID-19 case fatality rate by continent, year, and sex.
Fig. 3
Fig. 3
Sub-group meta-analysis proportion of hospitalized elderly COVID-19 case fatality rate by GDP per capita.
Fig. 4
Fig. 4
Trend of hospitalized elderly COVID-19 case fatality rate by year and female sex proportion.
See this image and copyright information in PMC

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References

    1. Girma D., Dejene H., Adugna L., Tesema M., Awol M. COVID-19 case fatality rate and factors contributing to mortality in Ethiopia: a systematic review of current evidence. Infection and Drug Resistance. 2022;15:3491. - PMC - PubMed
    1. Nakhlband A., Fakhari A., Azizi H. Interferon-alpha position in combating with COVID-19: a systematic review. Journal of Medical Virology. 2021;93(9):5277–5284. - PMC - PubMed
    1. WHO . World Health Organization; 2022. World health organization (WHO) coronavirus (COVID-19) dashboard.https://covid19.who.int/ URL: 2022.
    1. Kang S.-J., Jung S.I. Age-related morbidity and mortality among patients with COVID-19. Infection & Chemotherapy. 2020;52(2):154. - PMC - PubMed
    1. Damayanthi H., Prabani K., Weerasekara I. Factors associated for mortality of older people with COVID 19: a systematic review and meta-analysis. Gerontology and Geriatric Medicine. 2021;7 - PMC - PubMed