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人类新型冠状病毒感染(COVID-19):一项范围综述与荟萃分析

Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis.

作者信息

Borges do Nascimento Israel Júnior, Cacic Nensi, Abdulazeem Hebatullah Mohamed, von Groote Thilo Caspar, Jayarajah Umesh, Weerasekara Ishanka, Esfahani Meisam Abdar, Civile Vinicius Tassoni, Marusic Ana, Jeroncic Ana, Carvas Junior Nelson, Pericic Tina Poklepovic, Zakarija-Grkovic Irena, Meirelles Guimarães Silvana Mangeon, Luigi Bragazzi Nicola, Bjorklund Maria, Sofi-Mahmudi Ahmad, Altujjar Mohammad, Tian Maoyi, Arcani Diana Maria Cespedes, O'Mathúna Dónal P, Marcolino Milena Soriano

机构信息

University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 30130-100, Brazil.

Cochrane Croatia, University of Split School of Medicine, Split 21000, Croatia.

出版信息

J Clin Med. 2020 Mar 30;9(4):941. doi: 10.3390/jcm9040941.

Abstract

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%-99%; = 4410), cough (61%, 95% CI 39%-81%; = 3985), muscle aches and/or fatigue (36%, 95% CI 18%-55%; = 3778), dyspnea (26%, 95% CI 12%-41%; = 3700), headache in 12% (95% CI 4%-23%, = 3598 patients), sore throat in 10% (95% CI 5%-17%, = 1387) and gastrointestinal symptoms in 9% (95% CI 3%-17%, = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 10/L, 95% CI 0.83-1.03 × 10/L, = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54-45.91 mg/dL; = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%-1.0%; = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

摘要

关于2019新型冠状病毒(SARS-CoV-2)的文献越来越多,但尚未对现有数据进行综合分析。我们对目前可用的与SARS-CoV-2感染相关的临床、流行病学、实验室和胸部影像学数据进行了一项范围综述。我们检索了2019年1月1日至2020年2月24日期间的MEDLINE、Cochrane CENTRAL、EMBASE、Scopus和LILACS数据库。研究选择、数据提取和偏倚风险评估由两名独立的评审员进行。使用临床和实验室数据进行定性综合分析和荟萃分析,并应用随机效应模型估计汇总结果。共纳入61项研究(59254例患者)。最常见的疾病相关症状为发热(82%,95%置信区间(CI)56%-99%;n = 4410)、咳嗽(61%,95%CI 39%-81%;n = 3985)、肌肉疼痛和/或疲劳(36%,95%CI 18%-55%;n = 3778)、呼吸困难(26%,95%CI 12%-41%;n = 3700)、头痛(12%,95%CI 4%-23%,n = 3598例患者)、咽痛(10%,95%CI 5%-17%,n = 1387)和胃肠道症状(9%,95%CI 3%-17%,n = 1744)。实验室检查结果在较少患者中进行了描述,显示淋巴细胞减少(0.93×10⁹/L,95%CI 0.83-1.03×10⁹/L,n = 464)和C反应蛋白异常(33.72mg/dL,95%CI 21.54-45.91mg/dL;n = 1637)。影像学检查结果各不相同,但大多描述为磨玻璃影和实变。治疗选择的数据有限。全因死亡率为0.3%(95%CI 0.0%-1.0%;n = 53631)。流行病学研究表明,男性和老年患者的死亡率较高。大多数报告的与SARS-CoV-2感染相关的临床症状和实验室检查结果是非特异性的。临床怀疑并伴有相关的流行病学史后,应进行早期影像学检查和病毒学检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6aa/7230636/4fa54c470c82/jcm-09-00941-g001.jpg

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