» Articles » PMID: 32179124

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

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.

Citing Articles

Differences in COVID-19-Related Hospitalization, Treatment, Complications, and Death by Race and Ethnicity and Area-Level Measures Among Individuals with Cancer in the ASCO Registry.

Ashrafi A, Lin Y, Fong A, Islam J, Anderson T, Ganesan S Cancers (Basel). 2025; 17(5).

PMID: 40075704 PMC: 11898501. DOI: 10.3390/cancers17050857.


Dental service for United Nations peacekeepers coping with COVID-19 in Bukavu: preparation, implementation and recommendation.

Lu S, Miao L, He Y, Luo J, Lin L, Liu Z Front Oral Health. 2025; 6:1527777.

PMID: 40052120 PMC: 11882545. DOI: 10.3389/froh.2025.1527777.


Impact of self-efficacy and burnout on professional development of physical education teachers in the digital age: a systematic review.

Ma L, Chee C, Amri S, Gao X, Wang Q, Wang N PeerJ. 2025; 13:e18952.

PMID: 39995991 PMC: 11849512. DOI: 10.7717/peerj.18952.


A novel method for detecting SARS-CoV-2 IgM and IgG based on the gold immune chromatography assay.

Yao X, Xu H, Du Q, Lu X, Wang Q Sci Rep. 2025; 15(1):4995.

PMID: 39929938 PMC: 11811196. DOI: 10.1038/s41598-025-89012-1.


Evaluation of the Awareness and Anxiety Levels and Oral Hygiene Habits of University Students During the Coronavirus Disease 2019 (COVID-19) Pandemic.

Ertem E, Gursel M Cureus. 2024; 16(12):e75696.

PMID: 39677992 PMC: 11646645. DOI: 10.7759/cureus.75696.


References
1.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y . Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020; 382(13):1199-1207. PMC: 7121484. DOI: 10.1056/NEJMoa2001316. View

2.
Pongpirul W, Pongpirul K, Ratnarathon A, Prasithsirikul W . Journey of a Thai Taxi Driver and Novel Coronavirus. N Engl J Med. 2020; 382(11):1067-1068. PMC: 7121480. DOI: 10.1056/NEJMc2001621. View

3.
Paules C, Marston H, Fauci A . Coronavirus Infections-More Than Just the Common Cold. JAMA. 2020; 323(8):707-708. DOI: 10.1001/jama.2020.0757. View

4.
Dong E, Du H, Gardner L . An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020; 20(5):533-534. PMC: 7159018. DOI: 10.1016/S1473-3099(20)30120-1. View

5.
Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z . SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020; 382(12):1177-1179. PMC: 7121626. DOI: 10.1056/NEJMc2001737. View