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

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 I 2 . 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]). ) 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.

Predicting the Immunogenicity of T cell epitopes: From HIV to SARS-CoV-2

“…This suggests that memory T cells directed against less pathogenic coronaviruses could target immunogenic SARS-CoV-2 epitopes upon infection or following vaccination with a SARS-CoV-2 immunogen. Clinical outcomes and the course of disease during SARS-CoV-2 infection are extremely heterogeneous ranging from asymptomatic disease to death (Fu et al, 2020). Whether pre-exisiting HCoV specific memory Tcells actually play a disease modifying or even protective role needs to be determined.…”

25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2

“…However, only a fraction of infected people show clinical symptoms, and an even lower percentage require medical attention [1,2]. To date, it is not yet known why some patients develop more severe symptoms.…”

Potential of live pathogen vaccines for defeating the COVID‐19 pandemic: History and mechanism

“…Therefore, the morbidity and mortality of the total population due to COVID-19 is approximately 20% and 0.8%, respectively. 21,22 Because the adenovirus LPV with a single safety guarantee reduced adenovirus-associated ARD cases by 99.66% among the USA recruits, 15 we presume that the LPV strategy of SASR-CoV-2 with five safety mechanisms could reduce the morbidity by 90% to 2% and the CFR by 90% to 0.4%, and thus the mortality could decline by 99% to 0.008%, as compared with natural infections.…”

“…Most natural infections of SARS-CoV-2 are of no or mild symptoms, and the virus does not persist in most cases. 21,22 Second, like the adenovirus LPV, the LPV of SARS-CoV-2 is intestinally inoculated through enteric-coated capsules, in order to move the battlefield from the lungs to Accepted Article the intestine. The outcome of the viral infection is determined by the battle between the immune system and the virus.…”

“…Successful treatment of COVID-19 patients involves three respects: effectively inhibiting the virus replication which is the primary mechanism of the viral pathogenesis, effectively repairing the damages in the lungs and other organs caused by the battle between the host and the virus, and effectively combating secondary mixed infections. [22][23][24][25][26][27] Obviously, few drugs have excellent efficacy in all these three respects, and this has confused people in judging the efficacy of medications for COVID-19. Nevertheless, some medications including remdesivir, chloroquine, and some traditional Chinese medicine like the one termed Lianhuaqingwen, have excellent efficacy in reducing the virus replication in cell culture and inside patients.…”