Risk factors for Covid-19 severity and fatality: a structured literature review
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REVIEW
Risk factors for Covid‑19 severity and fatality: a structured literature review Dominik Wolff1 · Sarah Nee1 · Natalie Sandy Hickey1 · Michael Marschollek1 Received: 19 June 2020 / Accepted: 17 August 2020 © The Author(s) 2020
Abstract Purpose Covid-19 is a global threat that pushes health care to its limits. Since there is neither a vaccine nor a drug for Covid19, people with an increased risk for severe and fatal courses of disease particularly need protection. Furthermore, factors increasing these risks are of interest in the search of potential treatments. A systematic literature review on the risk factors of severe and fatal Covid-19 courses is presented. Methods The review is carried out on PubMed and a publicly available preprint dataset. For analysis, risk factors are categorized and information regarding the study such as study size and location are extracted. The results are compared to risk factors listed by four public authorities from different countries. Results The 28 records included, eleven of which are preprints, indicate that conditions and comorbidities connected to a poor state of health such as high age, obesity, diabetes and hypertension are risk factors for severe and fatal disease courses. Furthermore, severe and fatal courses are associated with organ damages mainly affecting the heart, liver and kidneys. Coagulation dysfunctions could play a critical role in the organ damaging. Time to hospital admission, tuberculosis, inflammation disorders and coagulation dysfunctions are identified as risk factors found in the review but not mentioned by the public authorities. Conclusion Factors associated with increased risk of severe or fatal disease courses were identified, which include conditions connected with a poor state of health as well as organ damages and coagulation dysfunctions. The results may facilitate upcoming Covid-19 research. Keywords Covid-19 · SARS-CoV-2 · Review · Risk factors · Population at risk
Introduction In the end of 2019, a novel respiratory disease, the coronavirus disease 2019 (Covid-19), occurred. The pathogen causing the disease was identified by next-generation sequencing as a novel coronavirus closely related to the SARS-coronavirus discovered in 2003 [1]. According to the WHO guidelines [2], this novel coronavirus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First cases of Covid-19 were reported from the Chinese city Wuhan located in the province Hubei in December 2019 [3]. The disease is spreading worldwide and was classified * Dominik Wolff [email protected] 1
Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
as a pandemic by the WHO in March 2020 [4]. The virus is transmissible from human to human [5] and the number of infected people increases at an exponential rate, exceeding 1 mio. cases on 02.04.2020 and 1.5 mio. cases in 184 countries only a week later [6, 7]. At various disease hotspots such as New York, the health care system reaches
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