Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis

Abstract

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 the pooled prevalence and 95% confidence interval (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%, 40.8-74.4%) and dyspnea (45.6%, 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 over 13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.

SARS-CoV-2 in Spanish Intensive Care Units: Early experience with 15-day survival in Vitoria

“…Table 1 compares current findings with first series of SARS-CoV2 in the ICU in China, USA, and 2009 pandemic influenza in Spain. Clinical presentation is consistent with a recent systematic review [9], lymphocytopenia and coagulation alterations being common at hospital admission, with some important differences documented when compared with pandemic influenza in 2009 (Table 1), as reported elsewhere [2], and also with the first ICU series reported from Wuhan [10].…”

Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study

“…Under CT, patients with COVID-19 may have some residual fibrotic lesions in the lungs following current treatment and discharge protocols [7], which may affect the patient's respiratory function. However, our study found that pulmonary function was significantly improved after 6 weeks of respiratory rehabilitation training.…”

COVID-19 in a tertiary hospital from Romania: Epidemiology, preparedness and clinical challenges

“…Most cases were mild; nevertheless 8 patients were addmited in ICU and 3 died (all 3 with epidemiological contact in a renal dialysis center, all with underlying diseases and with chronic renal dialysis). Apart from the already known [1] clinical features of COVID-19 (fever, cough, shortness of breath, myalgia, sore throat, headache or diarrhea) a sudden onset of anosmia and/or dysgeusia was registered in 20% of patients, all mild cases. Although anosmia has also been described in other respiratory virus infections (rhino-, entero-, adeno-, paramyxoviruses or syncytial respiratory virus) [5], it can represent an early indicator for COVID-19 and we advised ENT specialists to screen for SARS-CoV-2 in patients presenting with anosmia and dysgeusia.…”

“…Since December 2019 a new coronavirus, later named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), produced an atypical cluster of pneumonia, now known as Coronavirus Disease 2019 in China, Wuhan city area, and spread rapidly worldwide [1]. As with other severe respiratory infections, prevention is a challenge [2].…”