Background: The COVID-19 infection MESHD has caused 111652 deaths MESHD worldwide as of 13 April 2020. Risk factors for fatal outcomes of COVID-19 have varied across studies due to limited samples and have lacked effective qualitative and quantitative measurements. We performed a meta-analysis to evaluate risk factors for fatal outcomes of COVID-19.Methods: Data on demographic, clinic, laboratory findings and complications were extracted. Quantitative and qualitative synthesis was conducted for weighted-mean-difference (WMD) and odds-ratio (OR).Results: A total of 30 studies involving 5741 survivors and 1670 deaths MESHD were included. The death MESHD cases were significantly older than survivors (WMD=15.36, 95% CI: 12.90-17.82), male TRANS and smoking history showed higher risk to develop fatal outcome (OR=3.37, 95% CI: 2.27-5.01; OR=1.37, 95% CI: 1.02-1.83, respectively). The clinical symptoms including dyspnea MESHD dyspnea HP (OR=4.63, 95% CI: 2.85-7.54), hemoptysis MESHD hemoptysis HP (OR=3.11, 95% CI: 1.26-7.56), malaise (OR=2.44, 95% CI: 1.49-3.97). comorbidities with coronary heart disease MESHD (OR=4.36, 95% CI: 1.91-9.97), COPD (OR=3.70, 95% CI: 2.03-6.73) and cardiovascular disease MESHD (OR=3.45, 95% CI: 2.54-4.70). Compared to survivors, many laboratory indexes increased in deaths MESHD group, including serum SERO ferritin (WMD=741.47, 95% CI: 566.77-916.16), lactate dehydrogenase (WMD=226.86, 95% CI: 177.08-276.64) and myoglobin (WMD=102.58, 95% CI: 65.12-140.04), and the decreased indexes included PaO2/FiO2 (WMD=-71.61, 95% CI: -134.11 to -9.11), platelets (WMD=-41.09, 95% CI: -47.33 to -34.85) and PaO2 (WMD=-26.09, 95% CI: -38.9 to -13.29). Main complications contributed to the fatal outcome included sepsis MESHD sepsis HP (OR=184.61, 95% CI: 33.43-1019.42), shock MESHD shock HP (OR=133.76, 95% CI: 36.86-485.34) and respiratory failure HP (OR=47.37, 95% CI: 20.65-108.66). Conclusion: The main risk factors associated with fatal outcome of COVID-19 involved male TRANS, older age TRANS, smoking history, chronic medical conditions including coronary heart disease MESHD, COPD and cardiovascular disease MESHD, clinical symptoms including dyspnea MESHD dyspnea HP, hemoptysis MESHD hemoptysis HP and malaise, the increased laboratory indexes including serum SERO ferritin, lactate dehydrogenase and myoglobin, the decreased indexes including PaO2/FiO2, platelets and PaO2, main complications including sepsis MESHD sepsis HP, shock MESHD shock HP and respiratory failure HP. These factors could be considered in triaging patients and allocating medical resources when such medical resources are scarce, devising improved protocols for patient diagnosis and management, and developing new drugs and other therapies to treat COVID-19 patients.