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Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis
Alfonso J Rodriguez-Morales1, Jaime A Cardona-Ospina2, Estefanía Gutiérrez-Ocampo3
1Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Comittee on Tropical Medicine, Zoonoses and Travel Medicina, Asociación Colombiana de Infectología, Bogotá, DC, Colombia; Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Pereira, Risaralda, Colombia; Master in Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru.
Insights
This systematic review found that fever, cough, and dyspnea are common symptoms of Coronavirus Disease 2019 (COVID-19). Over 13% of hospitalized patients experienced fatal outcomes, highlighting the urgent need for healthcare preparedness.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- The emergence of Coronavirus Disease 2019 (COVID-19) has led to a global health crisis.
- Limited systematic reviews exist on the clinical, laboratory, and imaging features of COVID-19.
Purpose of the Study:
- To conduct a systematic literature review and meta-analysis of COVID-19.
- To assess the clinical, laboratory, imaging features, and outcomes of confirmed COVID-19 cases.
Main Methods:
- Systematic literature review and meta-analysis of three databases.
- Inclusion of observational studies and case reports, analyzed separately.
- Random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI).
Main Results:
- Fever (88.7%), cough (57.6%), and dyspnea (45.6%) were the most prevalent symptoms in 656 patients.
- 20.3% required intensive care unit (ICU) admission, 32.8% developed acute respiratory distress syndrome (ARDS), and 6.2% experienced shock.
- The case fatality rate (CFR) among hospitalized patients was 13.9%.
Conclusions:
- Coronavirus Disease 2019 imposes a significant burden on healthcare systems, particularly for patients with comorbidities.
- Approximately 20% of polymorbid patients required ICU care, and over 13% of hospitalizations resulted in death.
- Global spread necessitates urgent preparation of human resources, infrastructure, and facilities to manage severe COVID-19 cases.
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.
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