Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis

https://doi.org/10.1016/j.jcv.2020.104371Get rights and content

Highlights

  • Fever and cough are the most common symptoms in patients with COVID-19.

  • The most prevalent comorbidities are hypertension and diabetes which are associated with the severity of COVID-19.

  • ARDS and ACI may be the main obstacles to treatment recovery for patients.

  • The case severe rate and mortality is lower than that of SARS and MERS.

Abstract

Background

Since being first reported in Wuhan, China, in December 8, 2019, the outbreak of the novel coronavirus, now known as COVID-19, has spread globally. Some case studies regarding the characteristics and outcome of patients with COVID-19 have been published recently. We conducted a meta-analysis to evaluate the risk factors of COVID-19.

Methods

Medline, SinoMed, EMBASE, and Cochrane Library were searched for clinical and epidemiological studies on confirmed cases of COVID-19.

Results

The incidence of fever, cough, fatigue, and dyspnea symptoms were 85.6 % (95CI 81.3–89.9 %), 65.7 % (95CI 60.1–71.4 %), 42.4 % (95CI 32.2–52.6 %) and 21.4 % (95CI 15.3–27.5 %). The prevalence of diabetes was 7.7 % (95CI 6.1–9.3 %), hypertension was 15.6 % (95CI 12.6–18.6 %), cardiovascular disease was 4.7 % (95CI 3.1–6.2 %), and malignancy was 1.2 % (95CI 0.5–1.8 %). The complications, including ARDS risk, ranged from 5.6–13.2 %, with the pooled estimate of ARDS risk at 9.4 %, ACI at 5.8 % (95CI 0.7–10.8 %), AKI at 2.1 % (95CI 0.6–3.7 %), and shock at 4.7 % (95CI 0.9–8.6 %). The risks of severity and mortality ranged from 12.6 to 23.5% and from 2.0 to 4.4 %, with pooled estimates at 18.0 and 3.2 %, respectively. The percentage of critical cases in diabetes and hypertension was 44.5 % (95CI 27.0–61.9 %) and 41.7 % (95CI 26.4–56.9 %), respectively.

Conclusion

Fever is the most common symptom in patients with COVID-19. The most prevalent comorbidities are hypertension and diabetes which are associated with the severity of COVID-19. ARDS and ACI may be the main obstacles for patients to treatment recovery. The case severe rate and mortality is lower than that of SARS and MERS.

Abbreviations

COVID-19
corona virus disease
ACE2
angiotensin-converting enzyme 2
SARS
severe acute respiratory syndrome
MERS
middle east respiratory syndrome
ARDS
acute respiratory distress syndrome
ACI
acute cardiac injury
AKI
acute kidney injury
WHO
World Health Organization
CI
confidence interval
RCTs
randomized controlled trials
SD
standard deviation

Keywords

COVID-19
Comorbidities
Symptom
Severity
Mortality

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