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

Published time: 13 March 2020

Authors: Alfonso J. Rodriguez-Morales, Jaime A. Cardona-Ospina, Estefanía Gutiérrez-Ocampo, Rhuvi Villamizar-Peña, Yeimer Holguin-Rivera, Juan Pablo Escalera-Antezana, Lucia Elena Alvarado-Arnez, D. Katterine Bonilla-Aldana, Carlos Franco-Paredes, Andrés F. Henao-Martinez, Alberto Paniz-Mondolfi, Guillermo J. Lagos-Grisales, Eduardo Ramírez-Vallejo, Jose A. Suárez, Lysien I. Zambrano, Wilmer E. Villamil-Gómez, Graciela J. Balbin-Ramon, Ali A. Rabaan, Harapan Kuldeep, Dhama Hiroshi, Nishiura Hiromitsu, Kataoka Tauseef, Ahmad Ranjit Sah

Keywords: Coronavirus disease, 2019 SARS-CoV-2, Clinical features, Laboratory, Outcomes, Epidemic


Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date.

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 pooled prevalences and 95% confidence intervals (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%, 95%CI 40.8–74.4%) and dyspnea (45.6%, 95%CI 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>13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure, and facilities to treat severe COVID-19.

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



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