Leretter Marius Traian, Vulcanescu Dan Dumitru, Horhat Florin George, Matichescu Anamaria, Rivis Mircea, Rusu Laura-Cristina, Roi Alexandra, Racea Robert, Badea Ioana, Dehelean Cristina Adriana, Mocanu Alexandra, Horhat Delia Ioana
Department of Prosthodontics, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Exp Ther Med. 2022 Jun;23(6):424. doi: 10.3892/etm.2022.11350. Epub 2022 May 4.
Since the emergence of the disease in late December 2019, numerous studies have been published to date regarding clinical, laboratory and treatment aspects associated with COVID-19. The present study attempts to compare and unify the clinical, para-clinical and therapeutic aspects that have come to light regarding coronavirus disease-19 (COVID 19), mainly in adults. Between April 2020 and September 2021, a comprehensive systematic literature review was performed, which we added to from our own medical experiences. The search was performed on the PubMed, Scopus and Google Scholar databases, comprising studies with analyzable data that were identified alongside studies and documents containing general scientific data. All published studies were written in English, and were from different countries. A 95% confidence interval (CI95) was also calculated for almost each study using the Wilson formula. When compared with preliminary reports between December 2019 and January 2020, the most frequent symptoms were still identified as being fever (68.6%; CI95: 67.5-69.7) and cough (72.7%; CI95: 71.7-73.8). Nevertheless, asymptomatic cases also increased (by 21.4%; CI95: 16.6-27.1). Severe and critical cases accounted for 10.4% (CI95: 9.6-11.1) of all cases. The mean fatality rate was found to be 4% (CI95: 3.6-4.5). The primary co-morbidity found was hypertension (28.9%; CI95: 27-30.8), followed by other underlying cardiovascular diseases (15.4%; CI95: 13.9-16.9) and diabetes (14.5%; CI95: 13.1-16.1). The majority of studies showed lower white blood cell numbers with neutropenia and lymphopenia, and lower platelet levels. The levels of the biomarkers C-reaction protein and erythrocyte sedimentation rate were positive in all studied cases alongside other lab tests, such as examining the D-dimer levels and those of other hepatic, cardiac and renal injury markers. The procalcitonin level was also found to be elevated in many cases, resulting in high usage of antibiotics (83.7%; CI95: 81.2-85.9). Approximately 31.6% (CI95: 29.1-34.1) of the patients required non-invasive ventilation, whereas 9.9% (CI95: 8.1-12.1) of the patients were intubated or placed on extracorporeal membrane oxygenation. The most used antivirals were ribavirin (67.3%; CI95: 63.4-70.9), oseltamivir (52.5%; CI95: 49.4-55.5) and Arbidol™ (34.5%; CI95: 32-37.1). General admittance to the intensive care unit was ~7.2% (CI95: 6.5-7.9) of patients.
自该疾病于2019年12月底出现以来，截至目前已发表了大量关于新型冠状病毒肺炎（COVID-19）临床、实验室及治疗方面的研究。本研究旨在比较和统一已揭示的关于冠状病毒病-19（COVID-19）的临床、准临床和治疗方面，主要针对成年人。在2020年4月至2021年9月期间，进行了全面的系统文献综述，并结合了我们自己的医学经验。检索在PubMed、Scopus和谷歌学术数据库中进行，纳入了具有可分析数据的研究，以及包含一般科学数据的研究和文献。所有已发表的研究均为英文，且来自不同国家。几乎每项研究还使用威尔逊公式计算了95%置信区间（CI95）。与2019年12月至2020年1月的初步报告相比，最常见的症状仍然是发热（68.6%；CI95：67.5-69.7）和咳嗽（72.7%；CI95：71.7-73.8）。然而，无症状病例也有所增加（增加了21.4%；CI95：16.6-27.1）。重症和危重症病例占所有病例的10.4%（CI95：9.6-11.1）。平均病死率为4%（CI95：3.6-4.5）。发现的主要合并症是高血压（28.9%；CI95：27-30.8），其次是其他潜在心血管疾病（15.4%；CI95：13.9-16.9）和糖尿病（14.5%；CI95：13.1-16.1）。大多数研究显示白细胞数量减少，伴有中性粒细胞减少和淋巴细胞减少，血小板水平降低。生物标志物C反应蛋白和红细胞沉降率水平在所有研究病例中均呈阳性，其他实验室检查如D-二聚体水平以及其他肝、心、肾损伤标志物检查结果也是如此。许多病例中降钙素原水平也升高，导致抗生素使用率较高（83.7%；CI95：81.2-85.9）。约31.6%（CI95：29.1-34.1）的患者需要无创通气，而9.9%（CI95：8.1-12.1）的患者需要插管或接受体外膜肺氧合治疗。最常用的抗病毒药物是利巴韦林（67.3%；CI95：63.4-70.9）、奥司他韦（52.5%；CI95：49.4-55.5）和阿比多尔（34.5%；CI95：32-37.1）。入住重症监护病房的患者一般约占7.2%（CI95：6.5-7.9）。
