Clinical presentations, laboratory and radiological findings, and treatments for 11,028 COVID-19 patients: a systematic review and meta-analysis

Abstract

This systematic review and meta-analysis investigated the comorbidities, symptoms, clinical characteristics and treatment of COVID-19 patients. Epidemiological studies published in 2020 (from January-March) on the clinical presentation, laboratory findings and treatments of COVID-19 patients were identified from PubMed/MEDLINE and Embase databases. Studies published in English by 27th March, 2020 with original data were included. Primary outcomes included comorbidities of COVID-19 patients, their symptoms presented on hospital admission, laboratory results, radiological outcomes, and pharmacological and in-patient treatments. 76 studies were included in this meta-analysis, accounting for a total of 11,028 COVID-19 patients in multiple countries. A random-effects model was used to aggregate estimates across eligible studies and produce meta-analytic estimates. The most common comorbidities were hypertension (18.1%, 95% CI 15.4-20.8%). The most frequently identified symptoms were fever (72.4%, 95% CI 67.2-77.7%) and cough (55.5%, 95% CI 50.7-60.3%). For pharmacological treatment, 63.9% (95% CI 52.5-75.3%), 62.4% (95% CI 47.9-76.8%) and 29.7% (95% CI 21.8-37.6%) of patients were given antibiotics, antiviral, and corticosteroid, respectively. Notably, 62.6% (95% CI 39.9-85.4%) and 20.2% (95% CI 14.6-25.9%) of in-patients received oxygen therapy and non-invasive mechanical ventilation, respectively. This meta-analysis informed healthcare providers about the timely status of characteristics and treatments of COVID-19 patients across different countries.PROSPERO Registration Number: CRD42020176589.

Figure 1

PRISMA flowchart reporting identification, searching and selection processes.

Figure 2

Random-effects meta-analytic estimates for comorbidities. (A) Diabetes mellitus, (B) Hypertension, (C) Cardiovascular disease, (D) Chronic obstructive pulmonary disease, (E) Chronic kidney disease, (F) Cancer.

Figure 3

Random-effects meta-analytic estimates for presenting symptoms. (A) Fever, (B) Cough, (C) Dyspnoea, (D) Sore throat, (E) Muscle pain, (F) Headache.

Figure 4

Random-effects meta-analytic estimates for laboratory parameters. (A) White blood cell, (B) Lymphocyte, (C) Neutrophil, (D) C-creative protein, (E) D-dimer, (F) Lactate dehydrogenase.

Figure 5

Random-effects meta-analytic estimates for pharmacological treatments and intensive unit care at hospital. (A) Antiviral or interferon drugs, (B) Lopinavir/Ritonavir, (C) Interferon alpha (IFN-α), (D) Antibiotic drugs, (E) Corticosteroid, (F) Admission to Intensive care unit.

Figure 6

Random-effects meta-analytic estimates for radiological findings and non-pharmacological treatments at hospital. (A) Bilateral involvement, (B) Pneumonia, (C) Oxygen therapy, (D) Non-invasive ventilation, (E) Extracorporeal membrane oxygenation (ECMO), (F) Dialysis.