Epidemiologic, Clinical, and Laboratory Findings of the COVID-19 in the current pandemic: Systematic Review and Meta-analysis

Abstract

Background: The COVID-19 pandemic has affected the world deeply, with more than 3,000,000 people infected and nearly 200,000 deaths. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic.Methods: We scoped for relevant literatures published during 1st Dec 2019 to 23rd Apr 2020 based on four databases using English and Chinese languages. We reviewed and analyzed the relevant clinic outcomes of COVID-19.Results: The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number (R0) is 3.32 (95% CI:3.24-3.39), the incubation period was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1-39.0℃), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 ℃, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 60 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region.Conclusions: We provided a bird’s-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease’s future research, control and prevention.

Alternating quarantine for sustainable epidemic mitigation

“…More generally, our AQ strategy can, and should, be reinforced by other complementary policies, to ensure mitigation success, from avoiding social gatherings to establishing isolation facilities, with the purpose of reducing in-house transmission. As a specifically relevant example, we consider, in Supplementary Note 3.1, the selective protection of vulnerable populations, addressing a crucial aspect of COVID-19, whose impact on the elderly or on individuals with co-morbidities, is disproportionately more severe [46][47][48] . In Supplementary Note 3.2, we examine how population-wide testing can further enhance AQ's performance.…”

Susceptibility of the patients infected with Sars-Cov2 to oxidative stress and possible interplay with severity of the disease

“…Comorbidities are highly prevalent in patients who require intensive care. Several conditions have been demonstrated to be related to disease severity and poor outcomes, such as diabetes, cardiovascular diseases, and obesity [ [30] , [31] , [32] ]. Additionally, severity is also related to a high comorbidity index [ 33 ].…”

Coronavirus 2019 Infectious Disease Epidemic: Where We Are, What Can Be Done and Hope For

“…A total of 7 to 14 days after the onset of the symptoms, some patients may develop a severe clinical condition. This fraction of patients (estimated at w5%, and as high as 20%-40% among those admitted to a hospital 119,120,124 ) includes mostly elderly patients and/or patients with preexisting conditions (as previously mentioned. [118][119][120]124 Clinical clues of a more aggressive and potentially fatal outcome include fever greater than 39 C, conjunctivitis, neurologic symptoms, evidence of a hypercoagulation state such as ecchymosis of the fingers and toes, and patients who underwent cytoreductive chemotherapy within 4 weeks before the onset of the symptoms.…”

“…This fraction of patients (estimated at w5%, and as high as 20%-40% among those admitted to a hospital 119,120,124 ) includes mostly elderly patients and/or patients with preexisting conditions (as previously mentioned. [118][119][120]124 Clinical clues of a more aggressive and potentially fatal outcome include fever greater than 39 C, conjunctivitis, neurologic symptoms, evidence of a hypercoagulation state such as ecchymosis of the fingers and toes, and patients who underwent cytoreductive chemotherapy within 4 weeks before the onset of the symptoms. 120,[124][125][126][127] As the severity of COVID-19 symptoms increases, some patients develop dyspnea with hypoxia, and chest imaging exhibits the appearance of ground-glass opacities in the lung that subsequently acquire a crazy-paving pattern and may progress from single to multiple and confluent, ensuing in lung consolidation (Fig.…”

“…117 The main symptoms include fever, cough, fatigue, myalgia, pharyngodynia, diarrhea, anosmia, and ageusia. [118][119][120][121][122] More severe cases exhibit pneumonia, SARS, embolisms, diffuse intravascular coagulation, and eventually death. 123 The early infection phase includes an asymptomatic incubation of 1 to 14 days, followed by disease manifestations ( Fig.…”