Risk Factors for Mortality in Patients with Covid-19: A Systematic Review

 Ratna Yustinawati1), Anhari Achadi2)




Background: SARS-CoV-2, a new strain of the coronavirus, caused a global outbreak of fatal acute pneumonia. Globally, WHO has recorded 709,511 deaths from COVID-19, and the number is increasing. This study aimed to determine the risk factors for mortality in COVID-19 patients.

Subjects and Method: A systematic review was conducted by searching for articles from ScienceDirect, PubMed, SpringerLink, Scopus, and Google Scholar databases. The inclu­sion criteria were open access, English-language, and full-text articles published in jour­nals between December 2019 and Mei 2020. The keywords were (Coronavirus Disease 2019 AND clinical characteristics AND epidemiological characteristics AND comorbidities) OR (COVID-19 AND clinical characteristics AND epidemiological characteristics AND co­mor­bidities). A total of eight articles was reviewed to answer the research question. The data were analyzed by PRISMA flow chart.

Results: Based on the reports from China and Korea, a total of 1,314 (100%) COVID-19 patients who died was aged ≥60 years with comorbidity, in which 845 (64%) were male patients. Before the death of patients, the increase D-dimer level of ≥1 µg/ mL and Sequential Organ Failure Assessment (SOFA) score of ≥4 was reported.  It in­dicated the occurrence of multi-organ failure and Acute Respiratory Distress Syndrome (ARDS). Most of the comorbidities were hypertension, diabetes mellitus, and cardio­vas­cular diseases.

Conclusion: Risk factors for mortality in COVID-19 patients include age at ≥60 years, male, and presence of comorbidity. The clinical features are D-dimer levels ≥1 µg / mL, high SOFA score (≥4), and ARDS. Comprehensive efforts are needed to identify risk factors early and conduct effective treatment timely to reduce the mor­tality of COVID-19 patients.


Keywords: SARS-CoV-2, COVID-19, risk factors, mortality, comorbidity


Correspondence: Ratna Yustinawati. Master of Public Health Program, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia. Email: ratnayustinawati@gmail.com. Mobile: +628179324304.

DOI:  https://doi.org/10.26911/the7thicph-FP.01.01

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