Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis

Abstract

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%-99%; n = 4410), cough (61%, 95% CI 39%-81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%-55%; n = 3778), dyspnea (26%, 95% CI 12%-41%; n = 3700), headache in 12% (95% CI 4%-23%, n = 3598 patients), sore throat in 10% (95% CI 5%-17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%-17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 10 9 /L, 95% CI 0.83-1.03 × 10 9 /L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54-45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%-1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

Sex-Specific SARS-CoV-2 Mortality: Among Hormone-Modulated ACE2 Expression, Risk of Venous Thromboembolism and Hypovitaminosis D

“…Male sex represents 73% of deaths in China [8], 59% in South Korea [9] and, in Italy, ISS reports a prevalence of 70% of men among deceased people. A recent scoping review on all the available epidemiological studies, collecting data from 59,254 patients from 11 different countries, has shown an association between male sex and higher mortality rate [10]. These findings suggest the presence of a male-related susceptibility.…”

Respiratory conditions in coronavirus disease 2019 (COVID-19): Important considerations regarding novel treatment strategies to reduce mortality

“…A recently published meta-analysis examined the frequency and symptoms of COVID-19 in humans [4]. These investigators described that among the most common COVID-19 symptoms were fever (82%), cough (61%), muscle aches/fatigue (36%), dyspnea (26%), headache (12%), sore throat (10%), and gastrointestinal symptoms (9%).…”

“…In addition to the aforementioned common clinical symptoms of COVID-19, these investigators described detailed chest imaging results [4]. Among those with chest radiologic examinations, the most common abnormalities were opacities (bilateral or unilateral, with or without pleural effusion), multiple ground-glass opacities, and infiltrate.…”

“…As such, supportive management of COVID-19 with respiratory and ventilator support are standard therapeutic treatments [15]. A recent meta-analysis identified that the use of supplementary oxygen therapy (38.9%), invasive ventilation (28.7%), and even extracorporeal membrane oxygenation (ECMO) (0.9%) treatments were surprisingly high among 1,876 identified patients in which any kind of pharmacological and/or supportive intervention was reported [4].…”

SARS-CoV-2 Inflammatory Syndrome. Clinical Features and Rationale for Immunological Treatment

“…Clinical presentations of COVID-19 range from asymptomatic (81.4%), through mildly symptomatic with or without seasonal flu-like symptoms, to severe pneumonia (13.9%) [15]. Usually, respiratory problems manifest about one week after virus entry and dyspnea ranges from effort dyspnea to dyspnea occurring at rest [16,17].…”