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. 2023 Sep;114(3):604-613.
doi: 10.1002/cpt.2977. Epub 2023 Jul 20.

Prognostic Factors of COVID-19: An Umbrella Review Endorsed by the International Society for Pharmacoepidemiology

Grammati Sarri  1 , Wei Liu  2 , Luke Zabotka  3 , Andreas Freitag  1 , Ravinder Claire  4 , Grace Wangge  5 , Jamie Elvidge  4 , Dalia Dawoud  4   6 , Dimitri Bennett  7   8 , Xuerong Wen  9 , Xiaojuan Li  10 , Christopher T Rentsch  11   12 , Md Jamal Uddin  13   14 , M Sanni Ali  15   16 , Mugdha Gokhale  17 , Anouk Déruaz-Luyet  18 , Daniela C Moga  19 , Jeff Jianfei Guo  20 , Andrew R Zullo  21 , Elisabetta Patorno  3 , Kueiyu Joshua Lin  3
Affiliations

Prognostic Factors of COVID-19: An Umbrella Review Endorsed by the International Society for Pharmacoepidemiology

Grammati Sarri et al. Clin Pharmacol Ther. 2023 Sep.

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, the urgency for updated evidence to inform public health and clinical care placed systematic literature reviews (SLRs) at the cornerstone of research. We aimed to summarize evidence on prognostic factors for COVID-19 outcomes through published SLRs and to critically assess quality elements in the findings' interpretation. An umbrella review was conducted via electronic databases from January 2020 to April 2022. All SLRs (and meta-analyses) in English were considered. Data screening and extraction were conducted by two independent reviewers. AMSTAR 2 tool was used to assess SLR quality. The study was registered with PROSPERO (CRD4202232576). Out of 4,564 publications, 171 SLRs were included of which 3 were umbrella reviews. Our primary analysis included 35 SLRs published in 2022, which incorporated studies since the beginning of the pandemic. Consistent findings showed that, for adults, older age, obesity, heart disease, diabetes, and cancer were more strongly predictive of risk of hospitalization, intensive care unit admission, and mortality due to COVID-19. Male sex was associated with higher risk of short-term adverse outcomes, but female sex was associated with higher risk of long COVID. For children, socioeconomic determinants that may unravel COVID-19 disparities were rarely reported. This review highlights key prognostic factors of COVID-19, which can help clinicians and health officers identify high-risk groups for optimal care. Findings can also help optimize confounding adjustment and patient phenotyping in comparative effectiveness research. A living SLR approach may facilitate dissemination of new findings. This paper is endorsed by the International Society for Pharmacoepidemiology.

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Conflict of interest statement

CONFLICT OF INTEREST

G.S. and A.F. are employed by Cytel, Inc. D.B. is an employee of Takeda. L.Z. and M.S.A. report no declarations. X.L. receives research support from the NIH (R03AG070661 and K01AG073651). A.R.Z. receives grant funding paid directly to Brown University by Sanofi for collaborative research on the epidemiology of infections and vaccinations in nursing home residents and infants. A.R.Z. also receives grant funding from the U.S. National Institute on Aging (R01AG077620 and R01AG065722). E.P. is investigator of a research grant to the Brigham and Women’s Hospital from Boehringer-Ingelheim, not related to the topic of this work. E.P. receives research grants from the Patient Centered Outcomes Research Institute (DB-2020C2–20326) and the US Food and Drug Administration (5U01FD007213), not related to the topic of this work. All other authors declared no competing interests for this work.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart. COVID-19, coronavirus disease 2019; SLRs, systematic literature reviews. [Color figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Distribution of predictors and risk factors across the included SLRs. aThe same SLR can appear in multiple boxes. bAsthma, frailty, allergic airway disease, Parkinson’s disease, cancer, diabetes, atrial arrhythmias, and coronary artery disease. COVID-19, coronavirus disease 2019; SLR, systematic literature review. [Color figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
Common methodological challenges when identifying the role of COVID-19 predictors and risk factors in systematic literature reviews. COVID-19, coronavirus disease 2019. [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

References

    1. The COVID decade: understanding the long-term societal impacts of COVID-19. The British Academy; <https://www.thebritishacademy.ac.uk/publications/covid-decade-understand...>. Accessed January 5, 2023.
    1. Osterrieder A et al. Economic and social impacts of COVID-19 and public health measures: results from an anonymous online survey in Thailand, Malaysia, the UK, Italy and Slovenia. BMJ Open 11, e046863 (2021). - PMC - PubMed
    1. Sharma J, Rajput R, Bhatia M, Arora P & Sood V Clinical predictors of COVID-19 severity and mortality: a perspective. Front. Cell. Infect. Microbiol. 25, 674277 (2021). - PMC - PubMed
    1. Gough D et al. Evidence Synthesis International (ESI): position statement. Syst. Rev 9, 155 (2020). - PMC - PubMed
    1. Elliott J et al. Decision makers need constantly updated evidence synthesis. Nature 600, 383–385 (2021). - PubMed

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