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Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis
  1. Jieyun Zhu,
  2. Zhimei Zhong,
  3. Pan Ji,
  4. Hongyuan Li,
  5. Bocheng Li,
  6. Jielong Pang,
  7. Jianfeng Zhang and
  8. Chunling Zhao
  1. Department of Emergency Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
  1. Correspondence to Prof. Jianfeng Zhang; zhangjianfeng{at}stu.gxmu.edu.cn; Dr. Chunling Zhao; chunlingzhao2018{at}163.com

Abstract

Objective Our study aims to present a summary of the clinicopathological characteristics of patients affected by the coronavirus disease 2019 (COVID-19) that can be used as a reference for further research and clinical decisions.

Design Studies were included in the meta-analysis if they had cohort, case–control or case series designs and provided sufficient details on clinical symptoms, laboratory outcomes and asymptomatic patients.

Setting PubMed, Embase, Chinese Biomedical Literature Database, Wanfang, China Science and Technology Journal Database and China National Knowledge Infrastructure databases were electronically searched to identify related studies published between 1 January 2020 and 16 March 2020. Three reviewers independently examined the literature, extracted relevant data and assessed the risk of publication bias before including the studies in the meta-analysis.

Participants The confirmed cases of COVID-19.

Results A total of 55 unique retrospective studies involving 8697 patients with COVID-19 were identified. Meta-analysis showed that a higher proportion of infected patients were male (53.3%), and the two major symptoms observed were fever (78.4%) and cough (58.3%). Other common symptoms included fatigue (34%), myalgia (21.9%), expectoration (23.7%), anorexia (22.9%), chest tightness (22.9%) and dyspnoea (20.6%). Minor symptoms included nausea and vomiting (6.6%), diarrhoea (8.2%), headache (11.3%), pharyngalgia (11.6%), shivering (15.2%) and rhinorrhea (7.3%). About 5.4% of the patients were asymptomatic. Most patients showed normal leucocyte counts (64.7%) and elevated C reactive protein levels (65.9%). Lymphopaenia was observed in about 47.6% of the infected patients, along with abnormal levels of myocardial enzymes (49.4%) and liver function (26.4%). Other findings included leucopenia (23.5%), elevated D-dimer (20.4%), elevated erythrocyte sedimentation rate (20.4%), leucocytosis (9.9%), elevated procalcitonin (16.7%) and abnormal renal function (10.9%).

Conclusions The most commonly experienced symptoms of patients with COVID-19 were fever and cough. Myalgia, anorexia, chest tightness and dyspnoea were found in some patients. A relatively small percentage of patients were asymptomatic and could act as carriers of the disease. Most patients showed normal leucocyte counts, elevated levels of C reactive protein and lymphopaenia, confirming the viral origin of the disease.

  • communicable disease control
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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Correction notice This article has been corrected since it was published Online First. The article type has been modified from 'Original research' to 'Review'.

  • Contributors PJ, JP and BL collected and analysed the data. HL helped collect the data. JZ acquired the funding. JZ designed the study, and wrote the first draft of the manuscript. CZ and JZ designed and supervised the study, and finalised the manuscript, which all authors read and approved.

  • Funding This study was supported by grants from the National Natural Science Foundation of China (81960343); the Emergency Science and Technology Brainstorm Project for the Prevention and Control of COVID-19, which is part of the Guangxi Key Research and Development Plan (2020AB39028).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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