Clinical Characteristics and Diagnostic Challenges of COVID−19: An Update From the Global Perspective

Abstract

Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.

Clinical Predictors of COVID-19 Severity and Mortality: A Perspective

“…Further, it is also important to stratify epidemiological data based on demographic characteristics and risk factors for adverse COVID-19 outcomes, to enable exact and aggressive patient care (Mesas et al, 2020). Based on the analysis in this work, we can conclude that careful monitoring of clinical data, risk factors and disease biomarkers (Israfil et al, 2021) may enable early determination of COVID-19-led severity. Such an early estimate would be helpful in efficient patient management and possibly minimize the related mortality.…”

Unknown Disease Outbreaks Detection: A Pilot Study on Feature-Based Knowledge Representation and Reasoning Model

“…Therefore, based on the early COVID-19 data in Wuhan, 2019, this study estimates that with the system's help, the detection and notification timeliness of the early COVID-19 pandemic can be reduced to 7.0-10.0 days, and the detection process can avoid being disturbed by human factors. Since the outbreak of the COVID-19 pandemic in 2019, various studies have focused on collecting and delineating the demographic, clinical, and outcomes data on confirmed cases, some of the patients' numbers are over thousands (28,29). However, the data from subsequent studies were obtained based on the increasing number of new scientific findings, as well as increasing awareness of the pandemic by hospitals, CDCs, and governments, which resulted in the strengthened prevention and control measurements of the pandemic.…”

“…Since the outbreak of the COVID-19 pandemic in 2019, various studies have focused on collecting and delineating the demographic, clinical, and outcomes data on confirmed cases, some of the patients' numbers are over thousands ( 28 , 29 ). However, the data from subsequent studies were obtained based on the increasing number of new scientific findings, as well as increasing awareness of the pandemic by hospitals, CDCs, and governments, which resulted in the strengthened prevention and control measurements of the pandemic.…”

“…For example, for the confirmed cases recruited after January 1, 2020, in China, 31.3% of cases had recently been to Wuhan, 71.8% of cases had contact with people from Wuhan ( 28 ), hence other detection methods, such as cluster screening, molecular tests, diagnostic imaging, and biochemical detections can be more effective after the initial outbreak ( 30 , 31 ). Moreover, the appearance of asymptomatic infections since 2020 has reduced the strength of using clinical characteristics for detection ( 29 , 32 , 33 ). Therefore, this study suggests that the data of the initial 41 patients with laboratory-confirmed COVID-19 infection in Wuhan is more suitable for evaluating our method.…”

Mentality of pregnant women and obstetric healthcare workers about prenatal SARS‐CoV‐2 testing: A regional survey over the first wave of the COVID‐19 pandemic in Japan

“…Polymerase chain reaction (PCR) testing is the current gold standard for detecting SARS-CoV-2 infection in patients suspected of having COVID-19 with a sensitivity of approximately 70%, but there are potentially false-positive or false-negative results on PCR testing. 8,9 Despite the introduction of prenatal PCR testing in some areas, it is completely unknown whether prenatal PCR testing contributes to reducing the anxiety of pregnant women or preventing nosocomial infections.…”