Preprint Article Version 3 Preserved in Portico This version is not peer-reviewed

Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

Version 1 : Received: 24 February 2020 / Approved: 25 February 2020 / Online: 25 February 2020 (12:19:14 CET)
Version 2 : Received: 29 February 2020 / Approved: 2 March 2020 / Online: 2 March 2020 (15:34:49 CET)
Version 3 : Received: 11 March 2020 / Approved: 11 March 2020 / Online: 11 March 2020 (10:35:01 CET)

A peer-reviewed article of this Preprint also exists.

Rodríguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C, Henao-Martinez AF, Paniz-Mondolfi A, Lagos-Grisales GJ, Ramírez-Vallejo E, Suárez JA, Zambrano LI, Villamil-Gómez WE, Balbin-Ramon GJ, Rabaan AA, Harapan H, Dhama K, Nishiura H, Kataoka H, Ahmad T, Sah R, On behalf of the Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19) (www.lancovid.org). Clinical, Laboratory and Imaging Features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020 Epub Ahead March 13 https://www.sciencedirect.com/science/article/pii/S1477893920300910 (Indexed on Medline/Index Medicus) Rodríguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C, Henao-Martinez AF, Paniz-Mondolfi A, Lagos-Grisales GJ, Ramírez-Vallejo E, Suárez JA, Zambrano LI, Villamil-Gómez WE, Balbin-Ramon GJ, Rabaan AA, Harapan H, Dhama K, Nishiura H, Kataoka H, Ahmad T, Sah R, On behalf of the Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19) (www.lancovid.org). Clinical, Laboratory and Imaging Features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020 Epub Ahead March 13 https://www.sciencedirect.com/science/article/pii/S1477893920300910 (Indexed on Medline/Index Medicus)

Journal reference: Travel Medicine and Infectious Disease 2020
DOI: 10.1016/j.tmaid.2020.101623

Abstract

Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. 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 (1/1/2020-2/23/2020). After screening by abstract/title, 27 articles were selected for full-text assessment. Of them, 19 were 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), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) of hospitalized patients with 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 this group 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.

Subject Areas

Coronavirus Disease 2019; SARS-CoV-2; clinical features; laboratory; outcomes; epidemic.

Comments (1)

Comment 1
Received: 11 March 2020
Commenter: Alfonso J. Rodriguez-Morales
Commenter's Conflict of Interests: Author
Comment: We included additional references. We modified some aspects of the writing. We updated the number of cases and other epidemiological indicators. Improved some aspects of the methodology for better understanding.
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