Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

Abstract

Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a PublicHealth Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods:We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of confirmed cases of COVID-19. All the observational studies, and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Measures of heterogeneity were estimated and reported.Results: 660 articles were retrieved. After screening by abstract and title, 27 articles were selected for full-text assessment.Of them, 19 were 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%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent clinical manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) with a fatal outcome.Discussion: COVID-19 is a new clinical infectious disease, causing considerable compromise, especially in patients with comorbidities, requiring ICU in at least a fifth of them and sometimes with fatal outcomes. Additional research is needed to elucidate factors that may mediate the pathogenesis of the severe and fatal associated disease.

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“…Clinically, TB presents with fever, cough, and dyspnea, among other symptoms. Despite the differences in the duration of incubation and others, these three symptoms are also the clinical features observed in most patients with COVID-19, with prevalence of 88.7% (84.5-92.9%), 57.6% (40.8-74.4%), and 45.6% (10.9-80.4%), respectively [12]. Additionally, the WHO African region accounts for 93% of total malaria cases and 94% of total malaria deaths [13].…”

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“…While healthcare workers may accept an increased risk of infection as part of their chosen profession, they may have considerable anxiety about spreading the virus to their children, families and friends, especially those who are elderly or have chronic medical conditions, and perhaps even their pets, despite the evidence for this being limited [37,38]. Healthcare workers may wish to have alternative accommodation to avoid the risk of household transmission.…”

Conspiracy beliefs are associated with lower knowledge and higher anxiety levels regarding COVID-19 among students at the University of Jordan

“…The novel respiratory disease COVID-19, has a median incubation period of 5 days (2-14 days) with most common symptoms including fever, dry cough and fatigue [8]. Other signs and symptoms that were reported to a lesser degree included productive cough, dyspnea, myalgia, sore throat and headache [9].…”