Cardiovascular Research Department, Methodist Hospital, Merrillville, Indiana, USA.
Online Research Club, Nagasaki, Japan.
Rev Med Virol. 2021 Nov;31(6):e2288. doi: 10.1002/rmv.2288. Epub 2021 Sep 2.
SARS Coronavirus-2 is one of the most widespread viruses globally during the 21 century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.
SARS-CoV-2 是 21 世纪全球传播最广泛的病毒之一,其严重程度和引起严重肺炎和死亡的能力各不相同。我们对符合我们标准的所有研究进行了全面的系统评价,然后提取了有关 COVID-19 患者的年龄、症状和不同治疗方法以及该疾病在随访期间的预后的数据。本研究中的病例根据严重程度和死亡状态进行了划分,并分别使用原始均值和单比例方法进行了荟萃分析。我们纳入了 171 项完整的研究,包括 62909 例 COVID-19 确诊病例,其中 148 项研究进行了荟萃分析。症状明显呈递增趋势,从轻-中度症状、肺炎、严重-危重症到非幸存者组。高血压(合并比例(PP):0.48[95%置信区间(CI):0.35-0.61])、糖尿病(PP:0.23[95%CI:0.16-0.33])和吸烟(PP:0.12[95%CI:0.03-0.38])是在非幸存者组中,感染前合并症发生率最高的。而急性呼吸窘迫综合征(PP:0.49[95%CI:0.29-0.78])、(PP:0.63[95%CI:0.34-0.97])仍然是重症和死亡组中最常见的并发症之一。双侧磨玻璃影(PP:0.68[95%CI:0.59-0.75])是最明显的影像学图像。估计死亡率(PP:0.11[95%CI:0.06-0.19])、(PP:0.03[95%CI:0.01-0.05])和(PP:0.01[95%CI:0-0.3])分别在严重-危重症、肺炎和轻-中度组中。本研究可为 COVID-19 从轻度到重度的不同临床表现以及肺炎和死亡等特殊形式提供高证据指南。