COVID-19 Clinical Characteristics, Complications and Comorbidity: An Updated Systemic Review and Meta-Analysis

Abstract

Background: COVID-19, a novel pneumonia associated with the 2019 coronavirus infected pneumonia suddenly broke out in the world. The aim of this study is to summaries and analysis the clinical characteristics of COVID-19. Methods: Literatures have been systematically searched on Scopus, PubMed, Embase, Web of Science, and The Cochrane Library and also special databases prepared for COVID-19 such as LitCovid Hub, WHO, Elsevier, Medrxiv and CDC from inception up to May 1, 2020. Data searching, extracting and quality appraising were done by two researchers, independently. At last, Random-effects size based on Cochrane test and I2 were used. The Newcastle-Ottawa Scale was used to assess quality, and publication bias was analyzed by Egger and Begg’s test. The review protocol has been registered in PROSPERO with ID: CRD42020173639 and with ethical code IR.GUMS.REC.1398.542. Results: Out of 2464 studies, 75(3.04%) were included. A total of 111490 patients with a mean age of 49.43 years [Confidence Interval(CI)95%: 47.44-51.42] were evaluated. Most of patients was male (52.65%). The body mass index (BMI) in the most was in normal rate (23.26). 33.5% of patients were health care workers. 62.71% of patients had direct exposure history. The most common clinical symptoms were fever, cough, myalgia and dyspnea (82.72%, 57.69%; 25.20% and 20.87%, respectively). The most common comorbidities were acute respiratory distress syndrome, chronic medical illness, hypertension, and diabetes (30.4%, 22.25%, 17.47%, and 11.19% respectively). Among the laboratory abnormalities, the most patients had high levels of leucocytes (24.76%), lymphocyte (39.56%), increasing of neutrophil (14.48%), platelet (39.81%), D-dimer (30.89%), AST (22.09%), Creatinine (48.21%), troponin I (4.12%), urea nitrogen (22.94%), Creatine Kinase (48.21%), and C-reactive proteins (56.8%). About 37.35% of patients had a decreasing in the hemoglobin. CT-Scan funding shows that three fourths of patients had bilateral pneumonia involvement (78.25%), and 58.37% had GGO. Crazy-paving, vascular enlargement, air bronchus gram sign, and air trapping were seen in 22.55%, 61.79%, and 11.76%, respectively. The most common regions of the lung involvement were lower lobe 91.70%. Also, 66.34% of patients had peripheral involvement, and had punctate ground glass opacities (64.73%). Conclusion: COVID-19 is still a leading epidemic infection with comorbidities, clinical, laboratory and radiological findings, and its specific demographic characteristics. We found the rate of mortality of patients with COVID-19 is also decreasing, gradually. It could be related to the early recognition, early intervention, and early centered-quarantine of people in the world. Funding Statement: The author(s) received no specific funding for this work. Declaration of Interest: The authors have declared that no competing interests exist.