Comparison of Confirmed COVID-19 with SARS and MERS Cases - Clinical Characteristics, Laboratory Findings, Radiographic Signs and Outcomes: A Systematic Review and Meta-Analysis

Abstract

Introduction: In the current time where we face a COVID-19 pandemic, prevention, and rapid diagnosis of infected patients is crucial. Within this large-scale study, we compared clinical symptoms, laboratory findings, radiographic signs, and outcomes of COVID-19, SARS, and MERS to find unique features. Method: We searched all relevant literature published up to February 28, 2020, from Embase, Scopus, PubMed, Web of Science, and the Cochrane library to collect the studies that reported clinical and laboratory characteristics of corona-infected patients. The study quality was assessed with the Critical Appraisal Checklist. Depending on the heterogeneity test, we used either random or fixed-effect models to analyze the appropriateness of the pooled results. Result: Overall 114 articles included in this study; 52,251 COVID-19 confirmed patients (20 studies), 10,037 SARS (51 studies), and 8,139 MERS patients (43 studies) were included. The most common symptom among COVID-19 85.6 % (95% CI 73 -93, p < 0.001), SARS 96 % (95% CI 93-97.6, p < 0.001), and MERS 74 % (95% CI 63.5 -83.5, p < 0.001) was fever, respectively. Analysis showed that 84 % (95% CI 78-8.5, p < 0.001) of COVID-19 patients, 86% (95% 77-92, p < 0.001) of SARS patients, and 74.7% (95% 56.5-87, p < 0.001) of MERS patients had an abnormal chest X-ray. The mortality rate in COVID-19 5.6% (95% CI 2.5-12.5, p < 0.001), SARS 13 % (95% 9-17, p < 0.001), and MERS were 35 % (95% CI 31-39, p < 0.001) between all confirmed patients. Conclusions: Fever and cough are the most common symptoms of COVID-19, SARS, and MERS infected patients. Thrombocytosis in COVID-19 patients was more than twice as frequent as in SARS, and MERS confirmed cases. At the time of submission, the mortality rate in COVID-19 confirmed cases is lower than SARS and MERS infected patients. Clinical outcomes and findings would be biased by reporting only confirmed cases, and it should be considered when interpreting the data. Funding Statement: Dr. Bahr receives funding from the National Institutes of Neurological Diseases and Stroke of the National Institutes of Health, K23 NS110470. Declaration of Interests: The authors have declared that no competing interests exist. Ethics Approval Statement: Study has been registered in the PROSPERO database (ID 176106).