School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 510080, China.
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 510080, China; State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science & Technology, Tianjin, China; College of Food Science and Engineering, Tianjin University of Science & Technology, Tianjin, China.
J Infect. 2020 Jun;80(6):656-665. doi: 10.1016/j.jinf.2020.03.041. Epub 2020 Apr 10.
To better inform efforts to treat and control the current outbreak with a comprehensive characterization of COVID-19.
We searched PubMed, EMBASE, Web of Science, and CNKI (Chinese Database) for studies published as of March 2, 2020, and we searched references of identified articles. Studies were reviewed for methodological quality. A random-effects model was used to pool results. Heterogeneity was assessed using I. Publication bias was assessed using Egger's test.
43 studies involving 3600 patients were included. Among COVID-19 patients, fever (83.3% [95% CI 78.4-87.7]), cough (60.3% [54.2-66.3]), and fatigue (38.0% [29.8-46.5]) were the most common clinical symptoms. The most common laboratory abnormalities were elevated C-reactive protein (68.6% [58.2-78.2]), decreased lymphocyte count (57.4% [44.8-69.5]) and increased lactate dehydrogenase (51.6% [31.4-71.6]). Ground-glass opacities (80.0% [67.3-90.4]) and bilateral pneumonia (73.2% [63.4-82.1]) were the most frequently reported findings on computed tomography. The overall estimated proportion of severe cases and case-fatality rate (CFR) was 25.6% (17.4-34.9) and 3.6% (1.1-7.2), respectively. CFR and laboratory abnormalities were higher in severe cases, patients from Wuhan, and older patients, but CFR did not differ by gender.
The majority of COVID-19 cases are symptomatic with a moderate CFR. Patients living in Wuhan, older patients, and those with medical comorbidities tend to have more severe clinical symptoms and higher CFR.
通过全面描述 COVID-19 来更好地指导当前疫情的治疗和控制工作。
我们检索了截至 2020 年 3 月 2 日发表的 PubMed、EMBASE、Web of Science 和 CNKI（中国数据库）中的研究，并检索了已确定文章的参考文献。对研究进行了方法学质量评价。使用随机效应模型对结果进行汇总。使用 I2 评估异质性。使用 Egger 检验评估发表偏倚。
纳入了 43 项涉及 3600 例患者的研究。在 COVID-19 患者中，发热（83.3% [95%CI 78.4-87.7%]）、咳嗽（60.3% [54.2-66.3%]）和乏力（38.0% [29.8-46.5%]）是最常见的临床症状。最常见的实验室异常表现为 C 反应蛋白升高（68.6% [58.2-78.2%]）、淋巴细胞计数降低（57.4% [44.8-69.5%]）和乳酸脱氢酶升高（51.6% [31.4-71.6%]）。计算机断层扫描最常报告的发现是磨玻璃影（80.0% [67.3-90.4%]）和双侧肺炎（73.2% [63.4-82.1%]）。总体估计严重病例和病死率（CFR）的比例分别为 25.6%（17.4-34.9）和 3.6%（1.1-7.2）。严重病例、来自武汉的患者和老年患者的 CFR 和实验室异常更为严重，但性别之间的 CFR 没有差异。
大多数 COVID-19 病例有症状，CFR 适中。居住在武汉、老年患者和有合并症的患者往往有更严重的临床症状和更高的 CFR。
