Respiratory Rate and Systolic Blood Pressure on Hospital Admission as Prognostic Factor in COVID-19: A Systematic Review and Meta-Analysis

Main Article Content

Derren David C H Rampengan
Yorghi Liesapali
Nikita Pratama Toding Labi
Natalie Gabriela Edravenia Tombokan


Introduction: From December 2019 to September 10, 2021, More than 223 million people have been infected with COVID-19, resulting in more than 223 million 4.6 million deaths. The mortality rate is high in certain groups and particularly high in the absence of proven effective standard management measures. The use of a simple and accurate predictor for COVID-19 prognosis will be beneficial for the clinical management of patients. Therefore, we perform this systematic review and meta-analysis to reveal the association of specific clinical characteristics, that is respiratory rate (RR) and systolic blood pressure (SBP) on the first admission, with the COVID-19 severity.

Objective: To reveal the association of RR and SBP on first admission, with the COVID-19 severity.

Methods: We performed a systematic search in PubMed, ScienceDirect, and ProQuest for studies reporting clinical characteristics of mild and severe COVID-19 case. Included studies were evaluated for risk of bias based on Newcastle Ottawa Score. A meta-analysis was conducted using the data extracted from each study. Review Manager (RevMan) 5.4 was utilized to compute the summary of mean difference (MD) and 95% confidence intervals (CI) for the outcome.

Results: We included 6 studies involving 1,265 patients (severe cases=348 and mild cases=917), conducted in China, with several different outcomes. We found that increased RR (MD: 1.59; 95% CI: 0.31, 2.88; p<0.00001; I2= 86%) and increased SBP (MD: 5.27; 95% CI: 1.14, 9.40; p= 0.23; I2= 28%) and composite of both (MD: 2.09; 95% CI: 0.81, 3.38; p= 0.10; I2= 64.0%) were associated with severe COVID-19.

Conclusion: RR and SBP associated with the severity of COVID-19. Therefore, this clinical findings could be a prognostic factor of severe COVID-19 case among all the clinical manifestation. Longitudinal studies may reveal more long-term impacts of SARS-CoV-2 infection along the association of it's clinical manifestation.

Key Findings: COVID-19; Severity; Respiratory rate; Systolic blood pressure

Article Details

How to Cite
Rampengan, D. D. C. H., Liesapali, Y., Labi, N. P. T. and Tombokan, N. G. E. (2022) “Respiratory Rate and Systolic Blood Pressure on Hospital Admission as Prognostic Factor in COVID-19: A Systematic Review and Meta-Analysis”, Journal of Asian Medical Students’ Association. Kuala Lumpur, Malaysia. Available at: (Accessed: 25May2022).
Scientific Posters (AMSA Intl Academic Competition)


Bai T, Tu S, Wei Y, Xiao L, Jin Y, Zhang L, et al. Clinical and Laboratory factors predicting the prognosis of patients with COVID-19: An analysis of 127 patients in Wuhan, China. SSRN J. 2020; doi: 10.2139/ssrn.3546118

Chen X, Zheng F, Qing Y, Ding S, Yang D, Lei C, et al. Epidemiological and clinical features of 291 cases with coronavirus disease 2019 in areas adjacent to Hubei, China: a double-center observational study

Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-2629. doi:10.1172/JCI137244

Duan Q, Guo G, Ren Y, Shang H, Du J, Li M, et al. Treatment Outcomes, Influence Factors of 116 Hospitalized COVID-19 Patients with Longer/Prolonged Treatment Course in Wuhan, China. Lancet. 2020

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5

Shi Q, Zhao K, Yu J, Feng J, Zhao K, Zhang X. Clinical characteristics of 101 non-surviving hospitalized patients with COVID-19—A single center, retrospective study. MedRxiv. 2020; doi: 10.1101/2020.03.04.20031039