Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis
- PMID: 32179124
- PMCID: PMC7102608
- DOI: 10.1016/j.tmaid.2020.101623
Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis
Abstract
Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date.
Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI).
Results: 660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 95%CI 40.8-74.4%) and dyspnea (45.6%, 95%CI 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock. Some 13.9% (95%CI 6.2-21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR).
Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.
Keywords: Clinical features; Coronavirus disease 2019; Epidemic; Laboratory; Outcomes; SARS-CoV-2.
Copyright © 2020 Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of competing interest All authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential.
Comment in
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Rehabilitation of post-COVID-19 patients.Pan Afr Med J. 2020 Jul 9;36:168. doi: 10.11604/pamj.2020.36.168.23823. eCollection 2020. Pan Afr Med J. 2020. PMID: 32952812 Free PMC article. No abstract available.
References
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- Bonilla-Aldana D.K., Dhama K., Rodriguez-Morales A.J. Revisiting the one health approach in the context of COVID-19: a look into the ecology of this emerging disease. Adv Anim Vet Sci. 2020;8:234–237.
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