COVID-19 in China, Italy and the United States of America: a short review

Abstract

In December 2019, a novel coronavirus was discovered and associated with a cluster of pneumonia of unknown cause in China. SARS-CoV-2 rapidly spread and is now characterized as a pandemic. The objective of this study is to discuss COVID-19 general features, including epidemiology, transmission, control measures, virology, diagnosis, clinical characteristics and radiological and laboratory results. In this context, literature was assessed to compare the three most affected countries in Asia, Europe and Americas on March 31, 2020. The main form of transmission is human-to-human by respiratory secretions, and studies indicated substantial involvement of asymptomatic patients in this process. COVID-19 patients are predominantly men and may present multiple symptoms, especially fever and cough. Arterial hypertension and diabetes mellitus were the most common comorbidities. Worse outcomes are associated with increased age, comorbidities, and complications. Abnormalities in computed tomography of the chest are frequent, with pulmonary ground-glass opacity and bilateral patchy shadowing as the most common patterns, but a significant percentage of patients do not present any findings at time of admission. Laboratory results often present lymphocytopenia, increased neutrophils and platelet counts, erythrocyte sedimentation rate, lactate dehydrogenase, C-reactive protein, ferritin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, creatinine, creatine phosphokinase, myoglobin, glucose and cytokines. Although radiological findings and laboratory results presented similarities in China, Italy and USA, case-fatality rates can be conflicting suggesting, therefore, the need for studies according to each region.