Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Jun;80(6):656-665.
doi: 10.1016/j.jinf.2020.03.041. Epub 2020 Apr 10.

Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis

Leiwen Fu  1 , Bingyi Wang  2 , Tanwei Yuan  1 , Xiaoting Chen  3 , Yunlong Ao  3 , Thomas Fitzpatrick  4 , Peiyang Li  1 , Yiguo Zhou  1 , Yi-Fan Lin  5 , Qibin Duan  6 , Ganfeng Luo  1 , Song Fan  7 , Yong Lu  7 , Anping Feng  1 , Yuewei Zhan  1 , Bowen Liang  1 , Weiping Cai  3 , Lin Zhang  8 , Xiangjun Du  1 , Linghua Li  9 , Yuelong Shu  10 , Huachun Zou  11
Affiliations
Meta-Analysis

Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis

Leiwen Fu et al. J Infect. 2020 Jun.

Abstract

Objective: To better inform efforts to treat and control the current outbreak with a comprehensive characterization of COVID-19.

Methods: We searched PubMed, EMBASE, Web of Science, and CNKI (Chinese Database) for studies published as of March 2, 2020, and we searched references of identified articles. Studies were reviewed for methodological quality. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Publication bias was assessed using Egger's test.

Results: 43 studies involving 3600 patients were included. Among COVID-19 patients, fever (83.3% [95% CI 78.4-87.7]), cough (60.3% [54.2-66.3]), and fatigue (38.0% [29.8-46.5]) were the most common clinical symptoms. The most common laboratory abnormalities were elevated C-reactive protein (68.6% [58.2-78.2]), decreased lymphocyte count (57.4% [44.8-69.5]) and increased lactate dehydrogenase (51.6% [31.4-71.6]). Ground-glass opacities (80.0% [67.3-90.4]) and bilateral pneumonia (73.2% [63.4-82.1]) were the most frequently reported findings on computed tomography. The overall estimated proportion of severe cases and case-fatality rate (CFR) was 25.6% (17.4-34.9) and 3.6% (1.1-7.2), respectively. CFR and laboratory abnormalities were higher in severe cases, patients from Wuhan, and older patients, but CFR did not differ by gender.

Conclusions: The majority of COVID-19 cases are symptomatic with a moderate CFR. Patients living in Wuhan, older patients, and those with medical comorbidities tend to have more severe clinical symptoms and higher CFR.

Keywords: COVID-19; Clinical characteristics; Meta-analysis; Systematic review.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare having no conflict of interest related to this work.

Figures

Fig. 1
Fig. 1
Flow diagram of publication selection *Figure legend: COVID-19: Corona Virus Disease 2019.
Fig. 2
Fig. 2
Meta-analysis of the prevalence of clinical symptoms among COVID-19 patients.
Fig. 3
Fig. 3
Meta-analysis of the prevalence of laboratory findings among COVID-19 patients.
Fig. 4
Fig. 4
Meta-analysis of the prevalence of chest CT findings, complications, severe cases, and mortality among COVID-19 patients *Figure legend: ARDS=Acute Respiratory Distress Syndrome.
See this image and copyright information in PMC

Comment in

  • Tumor biomarkers predict clinical outcome of COVID-19 patients.
    He B, Zhong A, Wu Q, Liu X, Lin J, Chen C, He Y, Guo Y, Zhang M, Zhu P, Wu J, Wang C, Wang S, Xia X. He B, et al. J Infect. 2020 Sep;81(3):452-482. doi: 10.1016/j.jinf.2020.05.069. Epub 2020 Jun 11. J Infect. 2020. PMID: 32504736 Free PMC article. No abstract available.

References

    1. Huang C., Wang Y., Li X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. - PMC - PubMed
    1. WHO main website. https://www.who.int(accessed March 2, 2020).
    1. Zhu N., Zhang D., Wang W. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727–733. - PMC - PubMed
    1. Lu R., Zhao X., Li J. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020 - PMC - PubMed
    1. Chan J.F., Yuan S., Kok K.H. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395:514–523. - PMC - PubMed

Publication types