Department of Emergency, The Second Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic China.
J Med Virol. 2020 Oct;92(10):1902-1914. doi: 10.1002/jmv.25884. Epub 2020 Jun 24.
We aimed to systematically review the clinical characteristics of coronavirus disease 2019 (COVID-19). Seven databases were searched to collect studies about the clinical characteristics of COVID-19 from January 1, 2020 to February 28, 2020. Then, meta-analysis was performed by using Stata12.0 software. A total of 38 studies involving 3062 COVID-19 patients were included. Meta-analysis showed that a higher proportion of infected patients was male (56.9%). The incidence rate of respiratory failure or acute respiratory distress syndrome was 19.5% and the fatality rate was 5.5%. Fever (80.4%), fatigue (46%), cough (63.1%), and expectoration (41.8%) were the most common clinical manifestations. Other common symptoms included muscle soreness (33%), anorexia (38.8%), chest tightness (35.7%), shortness of breath (35%), dyspnea (33.9%). Minor symptoms included nausea and vomiting (10.2%), diarrhea (12.9%), headache (15.4%), pharyngalgia (13.1%), shivering (10.9%), and abdominal pain (4.4%). The proportion of patients that was asymptomatic was 11.9%. Normal leukocyte counts (69.7%), lymphopenia (56.5%), elevated C-reactive protein levels (73.6%), elevated ESR (65.6%), and oxygenation index decreased (63.6%) were observed in most patients. About 37.2% of patients were found with elevated D-dimer, 25.9% of patients with leukopenia, along with abnormal levels of liver function (29%), and renal function (25.5%). Other findings included leukocytosis (12.6%) and elevated procalcitonin (17.5%). Only 25.8% of patients had lesions involving a single lung and 75.7% of patients had lesions involving bilateral lungs. The most commonly experienced symptoms of COVID-19 patients were fever, fatigue, cough, and expectoration. A relatively small percentage of patients were asymptomatic. Most patients showed normal leucocytes counts, lymphopenia, elevated levels of C-reactive protein and ESR. Bilateral lung involvement was common.
系统评价 2019 年冠状病毒病(COVID-19)的临床特征。方法:检索 2020 年 1 月 1 日至 2020 年 2 月 28 日关于 COVID-19 临床特征的研究,纳入 7 个数据库,使用 Stata12.0 软件进行荟萃分析。结果:共纳入 38 项研究,涉及 3062 例 COVID-19 患者。荟萃分析显示,感染患者中男性比例较高(56.9%)。呼吸衰竭或急性呼吸窘迫综合征的发生率为 19.5%,病死率为 5.5%。发热(80.4%)、乏力(46%)、咳嗽(63.1%)、咳痰(41.8%)是最常见的临床表现。其他常见症状包括肌肉酸痛(33%)、食欲减退(38.8%)、胸闷(35.7%)、呼吸急促(35%)、呼吸困难(33.9%)。恶心呕吐(10.2%)、腹泻(12.9%)、头痛(15.4%)、咽痛(13.1%)、寒战(10.9%)、腹痛(4.4%)等症状也较常见。无症状患者比例为 11.9%。大多数患者白细胞计数正常(69.7%)、淋巴细胞减少(56.5%)、C 反应蛋白水平升高(73.6%)、红细胞沉降率升高(65.6%)、氧合指数下降(63.6%)。约 37.2%的患者 D-二聚体升高,25.9%的患者白细胞减少,肝功能异常(29%)、肾功能异常(25.5%)。白细胞增多(12.6%)和降钙素原升高(17.5%)也较为常见。仅有 25.8%的患者肺部受累为单侧,75.7%的患者肺部受累为双侧。COVID-19 患者最常见的症状是发热、乏力、咳嗽和咳痰。无症状患者比例较小。大多数患者白细胞计数正常,淋巴细胞减少,C 反应蛋白和红细胞沉降率升高。肺部双侧受累较为常见。