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Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis.
Travel Med Infect Dis. 2020 Mar - Apr; 34:101623.TM

Abstract

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.

Authors+Show Affiliations

Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Comittee on Tropical Medicine, Zoonoses and Travel Medicina, Asociación Colombiana de Infectología, Bogotá, DC, Colombia; Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Pereira, Risaralda, Colombia; Master in Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru. Electronic address: arodriguezm@utp.edu.co.Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Comittee on Tropical Medicine, Zoonoses and Travel Medicina, Asociación Colombiana de Infectología, Bogotá, DC, Colombia; Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Pereira, Risaralda, Colombia; Grupo de Investigación Infección e Inmunidad, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Semillero de Investigación en Infecciones Emergentes y Medicina Tropical, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Emerging Infectious Diseases and Tropical Medicine Research Group, Instituto para la Investigación en Ciencias Biomédicas - Sci-Help, Pereira, Risaralda, Colombia.Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.Universidad Franz Tamayo/UNIFRANZ, Cochabamba, Bolivia; National Responsible for Telehealth Program, Ministry of Health, La Paz, Bolivia.Universidad Franz Tamayo/UNIFRANZ, Cochabamba, Bolivia.Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Comittee on Tropical Medicine, Zoonoses and Travel Medicina, Asociación Colombiana de Infectología, Bogotá, DC, Colombia; Incubator in Zoonosis (SIZOO), Biodiversity and Ecosystem Conservation Research Group (BIOECOS), Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira, Risaralda, Colombia.Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Pereira, Risaralda, Colombia; Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA; Hospital Infantil de México Federico Gómez, México City, Mexico.Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA.Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Pereira, Risaralda, Colombia; Laboratory of Medical Microbiology, Department of Pathology, Molecular and Cell-based Medicine, The Mount Sinai Hospital-Icahn School of Medicine at Mount Sinai, New York, USA; Laboratorio de Señalización Celular y Bioquímica de Parásitos, Instituto de Estudios Avanzados (IDEA), Caracas, Caracas, Venezuela; Academia Nacional de Medicina, Caracas, Venezuela; Instituto de Investigaciones Biomedicas IDB / Incubadora Venez/olana de la Ciencia, Cabudare, Edo. Lara, Venezuela.Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.Comittee on Tropical Medicine, Zoonoses and Travel Medicina, Asociación Colombiana de Infectología, Bogotá, DC, Colombia; Investigador SNI Senacyt Panamá, Clinical Research Deparment, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panama.Department of Physiological and Morphological Sciences, School of Medical, Sciences, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras.Comittee on Tropical Medicine, Zoonoses and Travel Medicina, Asociación Colombiana de Infectología, Bogotá, DC, Colombia; Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Pereira, Risaralda, Colombia; Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Sucre, Colombia; Programa del Doctorado de Medicina Tropical, SUE Caribe, Universidad del Atlántico, Barranquilla, Colombia.Master in Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru; Hospital de Emergencias Jose Casimiro Ulloa, Lima, Peru.Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia; Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia; Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, 243 122, Bareilly, Uttar Pradesh, India.Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido, 060-8638, Japan.Hamamatsu University School of Medicine, Internal Medicine 3rd Division, Department of Cardiology, Hamamatsu, Shizuoka, Japan.Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.No affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32179124

Citation

Rodriguez-Morales, Alfonso J., et al. "Clinical, Laboratory and Imaging Features of COVID-19: a Systematic Review and Meta-analysis." Travel Medicine and Infectious Disease, vol. 34, 2020, p. 101623.
Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.
Rodriguez-Morales, A. J., Cardona-Ospina, J. A., Gutiérrez-Ocampo, E., Villamizar-Peña, R., Holguin-Rivera, Y., Escalera-Antezana, J. P., Alvarado-Arnez, L. E., Bonilla-Aldana, D. K., Franco-Paredes, C., Henao-Martinez, A. F., Paniz-Mondolfi, A., Lagos-Grisales, G. J., Ramírez-Vallejo, E., Suárez, J. A., Zambrano, L. I., Villamil-Gómez, W. E., Balbin-Ramon, G. J., Rabaan, A. A., Harapan, H., ... Sah, R. (2020). Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Medicine and Infectious Disease, 34, 101623. https://doi.org/10.1016/j.tmaid.2020.101623
Rodriguez-Morales AJ, et al. Clinical, Laboratory and Imaging Features of COVID-19: a Systematic Review and Meta-analysis. Travel Med Infect Dis. 2020 Mar - Apr;34:101623. PubMed PMID: 32179124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. AU - Rodriguez-Morales,Alfonso J, AU - Cardona-Ospina,Jaime A, AU - Gutiérrez-Ocampo,Estefanía, AU - Villamizar-Peña,Rhuvi, AU - Holguin-Rivera,Yeimer, AU - Escalera-Antezana,Juan Pablo, AU - Alvarado-Arnez,Lucia Elena, AU - Bonilla-Aldana,D Katterine, AU - Franco-Paredes,Carlos, AU - Henao-Martinez,Andrés F, AU - Paniz-Mondolfi,Alberto, AU - Lagos-Grisales,Guillermo J, AU - Ramírez-Vallejo,Eduardo, AU - Suárez,Jose A, AU - Zambrano,Lysien I, AU - Villamil-Gómez,Wilmer E, AU - Balbin-Ramon,Graciela J, AU - Rabaan,Ali A, AU - Harapan,Harapan, AU - Dhama,Kuldeep, AU - Nishiura,Hiroshi, AU - Kataoka,Hiromitsu, AU - Ahmad,Tauseef, AU - Sah,Ranjit, AU - ,, Y1 - 2020/03/13/ PY - 2020/02/29/received PY - 2020/03/11/revised PY - 2020/03/11/accepted PY - 2020/3/18/pubmed PY - 2020/5/19/medline PY - 2020/3/18/entrez KW - Clinical features KW - Coronavirus disease 2019 KW - Epidemic KW - Laboratory KW - Outcomes KW - SARS-CoV-2 SP - 101623 EP - 101623 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 34 N2 - 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. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/32179124/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(20)30091-0 DB - PRIME DP - Unbound Medicine ER -