Prevalence and clinical outcomes of pleural effusion in COVID-19 patients: A systematic review and meta-analysis.

Background Observational studies indicate that pleural effusion has an association with risk and the clinical prognosis of COVID-19 disease; however, the available literature on this area is inconsistent. The objective of this systematic review and meta-analysis is to evaluate the correlation between COVID-19 disease and pleural effusion. Methods A rigorous literature search was conducted using multiple databases. All eligible observational studies were included from around the globe. The pooled prevalence and associated 95% confidence interval (CI) were calculated using the random effect model. Mantel-Haenszel odds ratios were produced to report overall effect size using random effect models for severity and mortality outcomes. Funnel plots, Egger regression tests, and Begg-Mazumdar's rank correlation test were used to appraise publication bias. Result Data from 23 studies including 6234 COVID-19 patients was obtained. The overall prevalence of pleural effusion in COVID-19 patients was 9.55% (95% CI, I 2 =92%). Our findings also indicated that the presence of pleural effusions associated with increased risk of severity of disease(OR=5.08, 95% CI 3.14 to 8.22, I 2 = 77.4%) and mortality due to illness(OR=4.53, 95% CI 2.16 to 9.49, I 2 = 66%) compared with patients without pleural effusion. Sensitivity analyses illustrated a similar effect size while decreasing the heterogeneity. No significant publication bias was evident in the meta-analysis. Conclusion The presence of pleural effusion can assist as a prognostic factor to evaluate the risk of worse outcomes in COVID-19 patients hence, it is recommended that hospitalized COVID-19 patients with Pleural effusion should be managed on an early basis. This article is protected by copyright. All rights reserved.