- Title
- Clinical, laboratory and radiological characteristics and outcomes of novel coronavirus (SARS-CoV-2) infection in humans: a systematic review and series of meta-analyses
- Creator
- Borges do Nascimento, Israel Júnior; von Groote, Thilo Caspar; Cacic, Nensi; Zakarija-Grkovic, Irena; Meirelles Guimarães, Silvana Mangeon; Atallah, Alvaro Nagib; Bragazzi, Nicola Luigi; Marcolino, Milena Soriano; Marusic, Ana; Jeroncic, Ana; O'Mathúna, Dónal P.; Abdulazeem, Hebatullah Mohamed; Henderson, Catherine; Jayarajah, Umesh; Weerasekara, Ishanka; Pericic, Tina Poklepovic; Gerald Klapproth, Henning Edgar; Puljak, Livia
- Relation
- PLoS ONE Vol. 15, Issue 9, no. e0239235
- Publisher Link
- http://dx.doi.org/10.1371/journal.pone.0239235
- Publisher
- Public Library of Science (PLoS)
- Resource Type
- journal article
- Date
- 2020
- Description
- New evidence on the COVID-19 pandemic is being published daily. Ongoing high-quality assessment of this literature is therefore needed to enable clinical practice to be evidence-based. This review builds on a previous scoping review and aimed to identify associations between disease severity and various clinical, laboratory and radiological characteristics. We searched MEDLINE, CENTRAL, EMBASE, Scopus and LILACS for studies published between January 1, 2019 and March 22, 2020. Clinical studies including =10 patients with confirmed COVID-19 of any study design were eligible. Two investigators independently extracted data and assessed risk of bias. A quality effects model was used for the meta-analyses. Subgroup analysis and meta-regression identified sources of heterogeneity. For hospitalized patients, studies were ordered by overall disease severity of each population and this order was used as the modifier variable in meta-regression. Overall, 86 studies (n = 91,621) contributed data to the meta-analyses. Severe disease was strongly associated with fever, cough, dyspnea, pneumonia, any computed tomography findings, any ground glass opacity, lymphocytopenia, elevated C-reactive protein, elevated alanine aminotransferase, elevated aspartate aminotransferase, older age and male sex. These variables typically increased in prevalence by 30-73% from mild/early disease through to moderate/ severe disease. Among hospitalized patients, 30-78% of heterogeneity was explained by severity of disease. Elevated white blood cell count was strongly associated with more severe disease among moderate/severe hospitalized patients. Elevated lymphocytes, low platelets, interleukin-6, erythrocyte sedimentation rate and D-dimers showed potential associations, while fatigue, gastrointestinal symptoms, consolidation and septal thickening showed non-linear association patterns. Headache and sore throat were associated with the presence of disease, but not with more severe disease. In COVID-19, more severe disease is strongly associated with several clinical, laboratory and radiological characteristics. Symptoms and other variables in early/mild disease appear non-specific and highly heterogeneous.
- Subject
- COVID-19; computed axial tomography; fevers; metaanalysis; dyspnea; pneumonia; medical risk factors; coughing; Sustainable Development Goals; SDG 3
- Identifier
- http://hdl.handle.net/1959.13/1423522
- Identifier
- uon:37950
- Identifier
- ISSN:1932-6203
- Rights
- © 2020 Borges do Nascimento et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Language
- eng
- Full Text
- Reviewed
- Hits: 9278
- Visitors: 9439
- Downloads: 177
Collections
Goal 3: Good Health and Well-Being
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT02 | Publisher version (open access) | 1 MB | Adobe Acrobat PDF | View Details Download |