COVID-19 的临床表现： 102 项系统评价综述及证据图谱概述。
Clinical manifestations of COVID-19: An overview of 102 systematic reviews with evidence mapping.
机构信息
School of Public Health, Lanzhou University, Lanzhou, China.
Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, China.
出版信息
J Evid Based Med. 2022 Sep;15(3):201-215. doi: 10.1111/jebm.12483. Epub 2022 Jul 31.
OBJECTIVE
Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, but there is so far no comprehensive analysis of all known symptoms of the disease. Our study aimed to present a comprehensive picture of the clinical symptoms of COVID-19 using an evidence map.
METHODS
We systematically searched MEDLINE via PubMed, Web of Science, Embase, and Cochrane library from their inception to March 16, 2021. We included systematic reviews reporting the clinical manifestations of COVID-19 patients. We followed the PRISMA guidelines, and the study selection, data extraction, and quality assessment were done by two individuals independently. We assessed the methodological quality of the studies using AMSTAR. We visually presented the clinical symptoms of COVID-19 and their prevalence.
RESULTS
A total of 102 systematic reviews were included, of which, 68 studies (66.7%) were of high quality, 19 studies (18.6%) of medium quality, and 15 studies (14.7%) of low quality. We identified a total of 74 symptoms including 17 symptoms of the respiratory system, 21 symptoms of the neurological system, 10 symptoms of the gastrointestinal system, 16 cutaneous symptoms, and 10 ocular symptoms. The most common symptoms were fever (67 studies, ranging 16.3%-91.0%, pooled prevalence: 64.6%, 95%CI, 61.3%-67.9%), cough (68 studies, ranging 30.0%-72.2%, pooled prevalence: 53.6%, 95%CI, 52.1%-55.1%), muscle soreness (56 studies, ranging 3.0%-44.0%, pooled prevalence: 18.7%, 95%CI, 16.3%-21.3%), and fatigue (52 studies, ranging 3.3%-58.5%, pooled prevalence: 29.4%, 95%CI, 27.5%-31.3%). The prevalence estimates for COVID-19 symptoms were generally lower in neonates, children and adolescents, and pregnant women than in the general populations.
CONCLUSION
At least 74 different clinical manifestations are associated with COVID-19. Fever, cough, muscle soreness, and fatigue are the most common, but attention should also be paid to the rare symptoms that can help in the early diagnosis of the disease.
目的
新型冠状病毒病（COVID-19）已在全球迅速蔓延，但目前尚无对该疾病所有已知症状的综合分析。我们的研究旨在通过证据图谱呈现 COVID-19 临床症状的全貌。
方法
我们通过 PubMed 中的 MEDLINE、Web of Science、Embase 和 Cochrane 图书馆，从其创立开始至 2021 年 3 月 16 日进行了系统搜索。我们纳入了报告 COVID-19 患者临床表现的系统评价。我们遵循 PRISMA 指南，由两名独立人员进行研究选择、数据提取和质量评估。我们使用 AMSTAR 评估研究的方法学质量。我们直观地呈现了 COVID-19 的临床症状及其患病率。
结果
共纳入 102 项系统评价，其中 68 项研究（66.7%）质量较高，19 项研究（18.6%）质量中等，15 项研究（14.7%）质量较低。我们共确定了 74 种症状，包括 17 种呼吸系统症状、21 种神经系统症状、10 种胃肠道症状、16 种皮肤症状和 10 种眼部症状。最常见的症状是发热（67 项研究，范围 16.3%-91.0%，汇总患病率：64.6%，95%CI，61.3%-67.9%）、咳嗽（68 项研究，范围 30.0%-72.2%，汇总患病率：53.6%，95%CI，52.1%-55.1%）、肌肉酸痛（56 项研究，范围 3.0%-44.0%，汇总患病率：18.7%，95%CI，16.3%-21.3%）和乏力（52 项研究，范围 3.3%-58.5%，汇总患病率：29.4%，95%CI，27.5%-31.3%）。COVID-19 症状在新生儿、儿童和青少年以及孕妇中的患病率通常低于一般人群。
结论
至少有 74 种不同的临床表现与 COVID-19 相关。发热、咳嗽、肌肉酸痛和乏力最为常见，但也应注意有助于早期诊断疾病的罕见症状。
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