M.L.TAN1, P.S2, C.S3, K.S.R4, S.G.K5, C.O.C3, O.R6, V.G7, F.M5, A.V.M7, B.E2
Khoo Teck Puat Hospital1, Carilion Roanoke Memorial Hospital2, University of Nebraska Medical Center3, Rush University Medical Center4, University of Arizona-Banner University Medical Center5, University of Arkansas6, Woodlands Health7
The Coronavirus disease 2019 (COVID-19) was declared as a public emergency on January 30th,2020. As of March 26th,2020, there was 20,856 deaths reported worldwide without signs of slowing down. Many efforts have been directed to halt its transmissionm and hoping to find cure. We conducted this study to appraise the current data on the disease by meta-analysis and meta-regression methods.
We conducted a comprehensive search of several database from inception to March 25th,2020 to include studies reporting clinical characteristics and outcomes of hospitalised patients with COVID-19. The pooled rate of occurrence of various clinical symptoms, clinical work-up, complications and death were calculated. Randon effects model was used and heterogeneity was assessed by I²º⁄ο values and 95% prediction interval.
From a total of 27 studies including 4077 patients, our analysis showed that the pooled rates of fever, cough and myalgia/fatifue were 82.6%(CI 74.5-85.5), 63%(CI 57.4-68.2) and 29.5%(CI 22.3-37.9) respectively. Lymphopenia was noted in 57.5%(CI 44.5-69.5) and elevated CRP in 66.4%(CI 55.4-75.8). Ground glass opacities were seen in 62.8%(CI 52.3-72.2) and bilateral penumonia in 75.8%(CI 66.6-83). Based on meta-analysis, supplemental oxygen use and increased antiviral use with minimal stroids seem to reduce rate of death.
Fever, cough and fatigue are the most common presenting symptoms. Biomarkers which predict disease progression and complications include lymphopenia and elevated CRP. Diffuse ground glass opacities with bilateral pneumonia were the most common radiological findings. Supplemental oxygen therapy, antivirals and cautious use of corticosteroids are beneficial in reducing the rate of death.