Clinical Characteristics of 2019 Coronavirus Pneumonia (COVID-19): An Updated Systematic Review

Zhangfu Fang, Fang Yi, Kang Wu, Kefang Lai, Xizhuo Sun, Nanshan Zhong, Zhigang Liu

ARTICLE INFORMATIONMarch 12, 2020

This article is a preprint and has not been peer-reviewed. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

Note

facts of numbers

A total of 3470 COVID-19 patients were synthesized to the final analysis in an unbiased manner. The most common symptom was fever (2878 [83.0%]), and 63.4% of the patients presented fever as onset symptom. There were 2528 [88.2%] of 2866 cases had abnormal lung findings on chest CT scan. Laboratory findings showed that 1498 [62.8%] of 2387 cases had lymphopenia, and 1354 [64.8%] of 2091 cases had an increased level of C-reactive protein (CRP). A total of 185 [11.5%] patients were admitted to intensive care unit (ICU) while the overall case fatality rate (CFR) was 3.7%. Compared to patients admitted outside of Hubei, China, those from Hubei had a significant higher ICU admission rate (21.9% vs. 2.5%, p<0.001). Also, CFR attributed to COVID-19 was significantly higher in Hubei than that of non-Hubei admissions (10.4% vs. 0.6%, p<0.001). INTERPRETATION This large patient-based systematic review presents a more precise profiling of the COVID-19 from its outbreak to current pandemic. Dynamic evolvements of COVID-19 are needed to be characterized in future studies.

gender

The general ratio of male to female gender of the present study (1.10:1) is also similar to China CDC report (1.06:1), indicating that COVID-19 may not have a gender predisposition.

fever

Actually, we have learned from the SARS outbreak 17 years ago that early identification, early isolation and early management would lead to the stop of viral transmissions from human to human. Collectively, there were 36% of the COVID-19 patients absent from fever as the onset symptom. In this case, such patients may have been ignored at the early stage if we focused heavily on fever examination for initial screening.

Reference

medRxiv – https://www.medrxiv.org/content/10.1101/2020.03.07.20032573v2