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Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis.
Travel Medicine and Infectious Disease ( IF 6.3 ) Pub Date : 2020-03-13 , DOI: 10.1016/j.tmaid.2020.101623
Alfonso J Rodriguez-Morales 1 , Jaime A Cardona-Ospina 2 , Estefanía Gutiérrez-Ocampo 3 , Rhuvi Villamizar-Peña 3 , Yeimer Holguin-Rivera 3 , Juan Pablo Escalera-Antezana 4 , Lucia Elena Alvarado-Arnez 5 , D Katterine Bonilla-Aldana 6 , Carlos Franco-Paredes 7 , Andrés F Henao-Martinez 8 , Alberto Paniz-Mondolfi 9 , Guillermo J Lagos-Grisales 3 , Eduardo Ramírez-Vallejo 3 , Jose A Suárez 10 , Lysien I Zambrano 11 , Wilmer E Villamil-Gómez 12 , Graciela J Balbin-Ramon 13 , Ali A Rabaan 14 , Harapan Harapan 15 , Kuldeep Dhama 16 , Hiroshi Nishiura 17 , Hiromitsu Kataoka 18 , Tauseef Ahmad 19 , Ranjit Sah 20 ,
Affiliation  

Introduction

An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date.

Methods

We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI).

Results

660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being 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%, 95%CI 40.8–74.4%) and dyspnea (45.6%, 95%CI 10.9–80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0–30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7–51.8), 6.2% (95%CI 3.1–9.3) with shock. Some 13.9% (95%CI 6.2–21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR).

Conclusion

COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.

更新日期:2020-03-13
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