Abstract
The coronavirus disease 2019 (COVID-19) pandemic is straining global health resources, and the prevalence of severe disease appears to vary across countries. In accordance with PRISMA guidelines, we performed a systematic review and meta-analysis of clinical features and underlying medical conditions of COVID-19. Eighty-seven studies, involving 1,434,931 COVID-19 patients from the Americas, Asia, Europe, and Oceania, were included. Geographically, the rate of severity was highest in Asia (95% confidence interval (CI) 0.23‒0.30). The rates of comorbidities of COVID-19 patients in the Americas were significantly higher than those in Asia. Most Asian patients had fever (95%CI 0.70‒0.81), and most Oceanian patients had cough (95%CI 0.68‒0.70) as their prevalent symptom. Dyspnea was common in the Americas (95%CI 0.33‒0.64), Europe (95%CI 0.29‒0.64), and high latitude regions (95%CI 0.53‒0.82). European patients exhibited significantly high rates of loss of smell and taste (95%CI 0.60–0.97). In low-latitude regions, cancer (95%CI 14.50‒4.89) had the strongest correlation with illness severity. Comorbid diseases and clinical manifestations of severe COVID-19 patients vary substantially between latitudes and longitudes. Region-specific care should be considered to treat and improve the prognosis of COVID-19 patients.
Highlights
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
Mesenchymal stem cell (MSC) therapy was proposed to reduce acute lung injury and was tested in clinical trials to balance the inflammatory response induced by SARS-CoV2, especially in severe COVID-19 patients [6, 7]
As our study focused on comparing the clinical symptoms and underlying comorbidities of COVID-19 patients in different areas, we excluded studies that only reported on specific populations, such as patients in the ICU, children, or medical staff, and excluded case reports to avoid the associated bias
Summary
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. Mesenchymal stem cell (MSC) therapy was proposed to reduce acute lung injury and was tested in clinical trials to balance the inflammatory response induced by SARS-CoV2, especially in severe COVID-19 patients [6, 7]. Ere are many risk factors for severe morbidity and mortality in COVID-19 patients, such as sex, age, and underlying medical conditions, including coronary heart disease, diabetes, hypertension, lung diseases, and cancer [12, 13]. We analyzed the published scientific literature on COVID-19 patients in geographical regions, including the Americas, Asia, Europe, and Oceania, concerning the clinical characteristics of COVID-19 as well as its severity and risk of underlying medical conditions. We hypothesized that region-specific symptoms and population-specific comorbidities may be discovered to optimize treatment options and to improve care for COVID-19 patients, in a situation where no curable treatments are currently available
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