Clinical presentations, laboratory and radiological findings, and treatments for 11,028 COVID-19 patients: a systematic review and meta-analysis

Abstract

This systematic review and meta-analysis investigated the comorbidities, symptoms, clinical characteristics and treatment of COVID-19 patients. Epidemiological studies published in 2020 (from January–March) on the clinical presentation, laboratory findings and treatments of COVID-19 patients were identified from PubMed/MEDLINE and Embase databases. Studies published in English by 27th March, 2020 with original data were included. Primary outcomes included comorbidities of COVID-19 patients, their symptoms presented on hospital admission, laboratory results, radiological outcomes, and pharmacological and in-patient treatments. 76 studies were included in this meta-analysis, accounting for a total of 11,028 COVID-19 patients in multiple countries. A random-effects model was used to aggregate estimates across eligible studies and produce meta-analytic estimates. The most common comorbidities were hypertension (18.1%, 95% CI 15.4–20.8%). The most frequently identified symptoms were fever (72.4%, 95% CI 67.2–77.7%) and cough (55.5%, 95% CI 50.7–60.3%). For pharmacological treatment, 63.9% (95% CI 52.5–75.3%), 62.4% (95% CI 47.9–76.8%) and 29.7% (95% CI 21.8–37.6%) of patients were given antibiotics, antiviral, and corticosteroid, respectively. Notably, 62.6% (95% CI 39.9–85.4%) and 20.2% (95% CI 14.6–25.9%) of in-patients received oxygen therapy and non-invasive mechanical ventilation, respectively. This meta-analysis informed healthcare providers about the timely status of characteristics and treatments of COVID-19 patients across different countries.PROSPERO Registration Number: CRD42020176589

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“…During this first phase, about five days after infection, patients suffer from substantial viral replication [ 75 ]. During this phase, the primary symptoms are mostly fever (88.7%), coughing (57.6%), and dyspnea (45.6%) [ 14 , [75] , [76] , [77] ]. Other common symptoms include malaise (29.6%), fatigue (28.2%), neurological symptoms (20.8%), myalgia (16.9%), headaches, diarrhea, and anosmia [ 14 ].…”

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“…Multivariate analysis revealed that at the hospital's point of admission, pneumonic changes in chest radiograph were suggestive of bacterial co-infection among the COVID-19 patients and demands prudent use of antimicrobials 54 . Similarly, multiple research studies revealed that only those COVID-19 patients with radiologically identified bilateral pulmonary infection required antimicrobials therapy [55][56][57][58][59][60] . The current US guideline does not recommend the empiric use of antimicrobials in COVID-19 if not supported by documentary evidence of secondary bacterial or fungal infections 55 .…”

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