Risk factors of COVID-19 mortality: a systematic review of current literature and lessons from recent retracted articles

Lee, Keum Hwa and Kim, Jae Seok and Hong, Sung Hwi and Sung, D. W. and Choi, Y. R. and Ahn, Y. T. and Kim, K. S. and Kim, S. and Lee, S. and Sim, W. and Kim, D. and Jun, B. and Yang, Jae Won and Yon, Dong Keon and Lee, Seung Won and Kim, Min Seo and Dragioti, Elena and Li, Han and Jacob, Louis and Koyanagi, Ai and Ghayda, Ramy A. and Shin, Jae Il and Smith, Lee (2020) Risk factors of COVID-19 mortality: a systematic review of current literature and lessons from recent retracted articles. European Review for Medical and Pharmacological Sciences, 24 (24). pp. 13089-13097. ISSN 2284-0729

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Official URL: https://www.europeanreview.org/article/24216

Abstract

OBJECTIVE: Recently, two influential articles that reported the association of (hydroxy)chloroquine or angiotensin converting enzyme (ACE) inhibitors and coronavirus disease 2019 (COVID-19) mortality were retracted due to significant methodological issues. Therefore, we aimed to analyze the same clinical issues through an improved research method and to find out the differences from the retracted papers. We systematically reviewed pre-existing literature, and compared the results with those of the retracted papers to gain a novel insight. MATERIALS AND METHODS: We extracted common risk factors identified in two retracted papers, and conducted relevant publication search until June 26, 2020 in PubMed. Then, we analyzed the risk factors for COVID-19 mortality and compared them to those of the retracted papers. RESULTS: Our systematic review demonstrated that most demographic and clinical risk factors for COVID-19 mortality were similar to those of the retracted papers. However, while the retracted paper indicated that both (hydroxy)chloroquine monotherapy and combination therapy with macrolide were associated with higher risk of mortality, our study showed that only combination therapy of hydroxychloroquine and macrolide was associated with higher risk of mortality (odds ratio 2.33; 95% confidence interval 1.63-3.34). In addition, our study demonstrated that use of ACE inhibitors or angiotensin receptor blockers (ARBs) was associated with reduced risk of mortality (0.77; 0.65-0.91). CONCLUSIONS: When analyzing the same clinical issues with the two retracted papers through a systematic review of randomized controlled trials and relevant cohort studies, we found out that (hydroxy)chloroquine monotherapy was not associated with higher risk of mortality, and that the use of ACE inhibitors or ARBs was associated with reduced risk of mortality in COVID-19 patients.

Item Type: Journal Article
Keywords: COVID-19, Review, Risk factors, Mortality
Faculty: COVID-19 Research Collection
Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 14 Dec 2020 15:39
Last Modified: 09 Sep 2021 18:51
URI: https://arro.anglia.ac.uk/id/eprint/706131

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