Coronavirus Disease (COVID-19) Pandemic: An Overview of Systematic Reviews

Abstract

Background: Navigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging and ongoing critical appraisal of this output is essential.We aimed to collate and summarize all published systematic reviews on the coronavirus disease .Methods: Nine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO's Global Research, LILACS and Epistemonikos) were searched from December 1, 2019 to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory and radiological findings) and quality assessment (AMSTAR 2). Meta-analysis on prevalence of clinical outcomes was performed.Results: Eighteen systematic reviews were included; one was empty. Using AMSTAR 2, confidence in the results of 13 reviews was rated as "critically low", one as "low", one as "moderate" and two as "high". Symptoms of COVID-19 were (range values of point estimates): fever (82-95%), cough with or without sputum (58-72%), dyspnea (26-59%), myalgia or muscle fatigue (29-51%), sore throat (10-13%), headache (8-12%) and gastrointestinal complaints (5-9%). Severe symptoms were more common in men. Elevated C-reactive protein (associated with lymphocytopenia) and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. Chest imaging described a frequent pattern of uni-or bilateral multilobar ground-glass opacity. Only one review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3% to 14%. Conclusions:Confidence in the results of most reviews was "critically low". Future studies and systematic reviews should adhere to established methodologies. The majority of included systematic reviews were hampered by imprecise search strategy and no previous protocol submission.All-cause mortality was 0.3% (95% CI 0.0%-1.0%). Epidemiological studies showed that mortality was higher in males and elderly patients. Clinical SymptomsThe incidence of symptoms were shown as following: Fever 82%, (CI) 56%-99%; Cough 61%, 95% CI 39%-81%; Muscle aches and/or fatigue 36%, 95% CI 18%-55%; Dyspnea 26%, 95% CI 12%-41%; Headache 12%, 95% CI 4%-23%; Sore throat 10%, 95% CI 5%-17% and gastrointestinal symptoms 9%,95% CI 3%-17%.

Research methodology and characteristics of journal articles with original data, preprint articles and registered clinical trial protocols about COVID-19

“…Multiple evidence synthesis organizations are now offering evidence collections, investing duplicate effort into similar activities [19]. Overview of systematic reviews published until March 24 indicated that the majority of systematic reviews on COVID-19 available by that date were of critically low methodological quality [20]. Hopefully, research collaborations will be set up to reduce the multiplication of effort in terms of synthesizing and appraising COVID-19 evidence [19].…”

Research methodology and characteristics of journal articles with original data, preprint articles and registered clinical trial protocols about COVID-19

“…Multiple evidence synthesis organizations are now offering evidence collections, investing duplicate effort into similar activities (18). Overview of systematic reviews published until March 24 indicated that the majority of systematic reviews on COVID-19 available by that date were of critically low methodological quality (19). Hopefully, research collaborations will be set up to reduce the multiplication of effort in terms of synthesizing and appraising COVID-19 evidence (18).…”

Social Group Optimization–Assisted Kapur’s Entropy and Morphological Segmentation for Automated Detection of COVID-19 Infection from Computed Tomography Images

“…Usually, experts recommend a chain of investigative tests to identify the cause, position, and harshness of pneumonia. The preliminary examinations, such as blood tests and pleural-fluid assessment, are performed clinically to detect the severity of the infection [18][19][20]. The image-assisted methods are also frequently implemented to sketch the disease in the lung, which can be additionally examined by an expert physician or a computerized arrangement to recognize the severity of the pneumonia.…”