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. 2022 Nov 2;2(11):e0001187.
doi: 10.1371/journal.pgph.0001187. eCollection 2022.

Risk factors for SARS-CoV-2 related mortality and hospitalization before vaccination: A meta-analysis

Hannah N Marmor  1 , Mindy Pike  2 , Zhiguo Alex Zhao  3 , Fei Ye  3 , Stephen A Deppen  1   2
Affiliations

Risk factors for SARS-CoV-2 related mortality and hospitalization before vaccination: A meta-analysis

Hannah N Marmor et al. PLOS Glob Public Health. .

Abstract

The literature remains scarce regarding the varying point estimates of risk factors for COVID-19 associated mortality and hospitalization. This meta-analysis investigates risk factors for mortality and hospitalization, estimates individual risk factor contribution, and determines drivers of published estimate variances. We conducted a systematic review and meta-analysis of COVID-19 related mortality and hospitalization risk factors using PRISMA guidelines. Random effects models estimated pooled risks and meta-regression analyses estimated the impact of geographic region and study type. Studies conducted in North America and Europe were more likely to have lower effect sizes of mortality attributed to chronic kidney disease (OR: 0.21, 95% CI: 0.09-0.52 and OR: 0.25, 95% CI: 0.10-0.63, respectively). Retrospective studies were more likely to have decreased effect sizes of mortality attributed to chronic heart failure compared to prospective studies (OR: 0.65, 95% CI: 0.44-0.95). Studies from Europe and Asia (OR: 0.42, 95% CI: 0.30-0.57 and OR: 0.49, 95% CI: 0.28-0.84, respectively) and retrospective studies (OR: 0.58, 95% CI: 0.47-0.73) reported lower hospitalization risk attributed to male sex. Significant geographic population-based variation was observed in published comorbidity related mortality risks while male sex had less of an impact on hospitalization among European and Asian populations or in retrospective studies.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram for article inclusion and exclusion.
Fig 2
Fig 2
a-l. Forest plots for individual study estimates and pooled estimates of risk factors associated with COVID-19 related mortality in studies using logistic regression.
Fig 3
Fig 3
a-g. Forest plots for individual study estimates and pooled estimates of risk factors associated with COVID-19 related mortality in studies using Cox regression.
Fig 4
Fig 4. Stratified mortality meta-analysis for chronic kidney disease by study region.
Fig 5
Fig 5
a-k. Forest plots for individual study estimates and pooled estimates of risk factors associated with COVID-19 related hospitalization.
See this image and copyright information in PMC

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