Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis

Zhu, Jieyun; Zhong, Zhimei; Pan, Jianji; Li, Hongyuan; Li, Bocheng; Pang, Jielong; Zhang, Jianfeng; Zhao, Chunling

doi:10.1136/fmch-2020-000406

Cited by 123 publications

(150 citation statements)

References 37 publications

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“…Bilateral lung in ltrates (76%) was the most common radiological nding reported in older patients. These ndings had a similar WPP to that reported in other age groups (33,37,43).…”

Section: Discussionsupporting

confidence: 89%

“…As compared to the other studies (33,34,37,43,44), fever and cough had similar WPP, however, dyspnoea was found to be more prevalent in older patients as compared to the younger ones. Similarly, though diarrhoea has been noted as the most common gastrointestinal symptom in other studies (33,43) too, it has comparatively higher WPP in older population. It is important to note that gastrointestinal symptoms are common in older population, and patients and physicians should keep a low threshold of suspicion for COVID 19 even in the absence of typical symptoms.…”

Section: Discussioncontrasting

confidence: 38%

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Clinical Features and Outcomes of COVID-19 in Older Adults: A Systematic Review and Meta-Analysis

Singhal

Kumar

Singh

et al. 2020

Preprint

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Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients.Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support.Result 46 studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2- 95%) patients while 22% (95% CI– 16-28%, I2- 88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2- 98%) patients died. The common comorbidities were hypertension (48%, 95% CI– 36-60% I2- 92%), diabetes mellitus (22%, 95% CI– 13-32%, I2- 86%) and cardiovascular disease (19%, 95% CI – 11-28%, I2- 85%). Common symptoms were fever (83%, 95% CI– 66-97%, I2-91%), cough (60%, 95% CI– 50-70%, I2- 71%) and dyspnoea (42%, 95% CI– 19-67%, I2- 94%). Overall, 84% (95% CI– 60-100%, I2- 81%) required oxygen support and 21% (95% CI– 0-49%, I2- 91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes.Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

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“…Bilateral lung in ltrates (76%) was the most common radiological nding reported in older patients. These ndings had a similar WPP to that reported in other age groups (33,37,43).…”

Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 38%

Clinical Features and Outcomes of COVID-19 in Older Adults: A Systematic Review and Meta-Analysis

Singhal

Kumar

Singh

et al. 2020

Preprint

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“…We identified 96 studies of COVID-19-related myalgia. After exclusion of descriptive reviews, data in other than English language, and duplicate studies, we selected 13 studies and 2 meta-analysis comprising of 10 and 55 studies, respectively (Table 1) [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Search Resultsmentioning

confidence: 99%

“…Patients diagnosed before January 31 had higher prevalence of fever and cough. The authors concluded that as the pandemic grew, the prevalence of atypical symptoms increased [15]. In a study of olfactory and gustatory function in COVID-19 patients by Lechien et al, more than 50% patients had myalgia [76].…”

Section: Myalgiamentioning

confidence: 99%

Neuromuscular presentations in patients with COVID-19

et al. 2020

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COVID-19 is caused by the coronavirus SARS-CoV-2 that has an affinity for neural tissue. There are reports of encephalitis, encephalopathy, cranial neuropathy, Guillain-Barrè syndrome, and myositis/rhabdomyolysis in patients with COVID-19. In this review, we focused on the neuromuscular manifestations of SARS-CoV-2 infection. We analyzed all published reports on SARS-CoV-2-related peripheral nerve, neuromuscular junction, muscle, and cranial nerve disorders. Olfactory and gustatory dysfunction is now accepted as an early manifestation of COVID-19 infection. Inflammation, edema, and axonal damage of olfactory bulb have been shown in autopsy of patients who died of COVID-19. Olfactory pathway is suggested as a portal of entry of SARS-CoV-2 in the brain. Similar to involvement of olfactory bulb, isolated oculomotor, trochlear and facial nerve has been described. Increasing reports Guillain-Barrè syndrome secondary to COVID-19 are being published. Unlike typical GBS, most of COVID-19-related GBS were elderly, had concomitant pneumonia or ARDS, more prevalent demyelinating neuropathy, and relatively poor outcome. Myalgia is described among the common symptoms of COVID-19 after fever, cough, and sore throat. Duration of myalgia may be related to the severity of COVID-19 disease. Few patients had muscle weakness and elevated creatine kinase along with elevated levels of acute-phase reactants. All these patients with myositis/rhabdomyolysis had severe respiratory complications related to COVID-19. A handful of patients with myasthenia gravis showed exacerbation of their disease after acquiring COVID-19 disease. Most of these patients recovered with either intravenous immunoglobulins or steroids.

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“…Therefore, a clinical definition of COVID-19 is not reliable and laboratory confirmation of SARS-CoV-2 is currently advised for confirmation [4]. As asymptomatic patients tested positive for SARS-CoV-2, the lack of test capacity resulted in a lack of knowledge of the underlying true infection risk [5,6]. Since then, test capacities have been upscaled, but there is still an urgent need for reliable and cost-effective high-throughput testing methods, specifically as regulations are currently easing and loci of rapid spread need to be detected as early as possible, to avoid uncontrolled viral spread.…”

Section: Introductionmentioning

confidence: 99%

Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by Mass Spectrometry

Wandernoth

Kriegsmann

Groh-Mohanu

et al. 2020

Viruses

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Background: Amplification of viral ribonucleic acid (RNA) by real-time reverse transcriptase polymerase chain reaction (rRT-PCR) is the gold standard to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the initial outbreak, strategies to detect and isolate patients have been important to avoid uncontrolled viral spread. Although testing capacities have been upscaled, there is still a need for reliable high throughput test systems, specifically those that require alternative consumables. Therefore, we tested and compared two different methods for the detection of viral PCR products: rRT-PCR and mass spectrometry (MS). Methods: Viral RNA was isolated and amplified from oro- or nasopharyngeal swabs. A total of 22 samples that tested positive and 22 samples that tested negative for SARS-CoV-2 by rRT-PCR were analyzed by MS. Results of the rRT-PCR and the MS protocol were compared. Results: Results of rRT-PCR and the MS test system were in concordance in all samples. Time-to-results was faster for rRT-PCR. Hands-on-time was comparable in both assays. Conclusions: MS is a fast, reliable and cost-effective alternative for the detection of SARS-CoV-2 from oral and nasopharyngeal swabs.

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Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis

Cited by 123 publications

References 37 publications

Clinical Features and Outcomes of COVID-19 in Older Adults: A Systematic Review and Meta-Analysis

Clinical Features and Outcomes of COVID-19 in Older Adults: A Systematic Review and Meta-Analysis

Neuromuscular presentations in patients with COVID-19

Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by Mass Spectrometry

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