Association Between Symptoms and Severity of Disease in Hospitalised Novel Coronavirus (COVID-19) Patients: A Systematic Review and Meta-Analysis

Abstract

Background Symptoms of the novel coronavirus disease (COVD-19) are well known, although asymptomatic cases were also reported due to this rapidly evolving viral disease. However, there has been limited research with inconsistent findings on symptoms of COVID-19 and disease severity. We aimed to evaluate the association between symptoms and severity of disease in adult patients with confirmed COVID-19 by performing a meta-analysis. Methods We conducted this study by searching four online databases (Medline, Web of Science, EMBASE and Cochrane library) of published studies that included symptoms of COVID-19 cases and severity of the disease between January 1, 2020, and October 31, 2021. PRISMA and MOOSE guidelines were followed, and only articles published in English were selected. We performed meta-analysis using Mantel-Haenszel random-effects model. Note that we included peer-reviewed studies conducted in Wuhan and published in the English language that reported the clinical characteristics of COVID-19, particularly the symptoms of novel coronavirus patients with their prevalence and distribution of patients based on the severity of the disease. Results Out of 255 articles identified, a total of twenty articles, including 5390 participants, met the inclusion criteria and were included. Among the participants, 2997 (55.60%) were males, and 974 (18.07%) reported severe conditions. Fever was the most commonly reported symptom in the reported COVID-19 confirmed cases (88.47%, 95% CI: 80.74–93.35%), which was followed by cough, fatigue, and less proportionally dyspnea and myalgia. Dyspnea was the only symptom, which was associated with severity of COVID-19 (OR 2.43, 95% CI: 1.52–3.89). Conclusion Dyspnoea was found to be associated with severity of COVID-19. People with existing respiratory illnesses, such as chronic obstructive pulmonary diseases need to be careful about the onset of such symptom and should seek medical attention.

Assessing Associations Between COVID-19 Symptomology and Adverse Outcomes After Piloting Crowdsourced Data Collection: Cross-sectional Survey Study

“…A comparison of our findings with those of other studies can be found in Multimedia Appendix 9. At the time of our analysis, we found 3 systematic review or meta-analysis studies mapping the association of symptoms with the risk of adverse outcomes of COVID-19 [19][20][21].…”

“…Common symptoms include fever, cough, fatigue, shortness of breath, and loss of the sense of smell or taste, and less frequent symptoms are gastrointestinal and neurological symptoms [4][5][6][13][14][15][16]. Although there has been a concerted effort to describe patients' symptoms [7,17,18], there is no evidence yet as to whether symptoms differ between people with different characteristics, such as chronic diseases and demographic backgrounds [19,20]. As individual symptoms cannot predict COVID-19 adverse outcomes [21], knowledge of a patient's profile of symptoms (ie, symptomology) holds promise to improve estimations of the risk of adverse outcomes [22].…”

Pulmonary function trajectories in COVID-19 survivors with- and without pre-existing respiratory disease at three and twelve months after hospital discharge

“…Within the Netherlands, 6.6 million cases have been con rmed until March 2023, from which around 9% of the people required hospitalization during the acute COVID-19 phase, thereby placing an immense burden on hospitals and health care systems [2]. Hospitalized COVID-19 patients most commonly presented symptoms such as fever, fatigue, cough, and dyspnoea, leading to the need of oxygen therapies and sometimes even admission to intensive care units (ICUs) during hospitalization [3,4].…”

The clinical practice of palliative sedation in patients dying from COVID-19: a retrospective chart review

“…During the COVID pandemic, there were different waves of reported patients with this infection. Although most patients had mild respiratory symptoms, in approximately 15% of the cases hospitalization was needed while in 5% the symptoms developed to a critical disease [ 1 ]. Increase in severity of illness was observed when dyspnoea was a present symptom [ 1 ].…”