Xiaobo He1, Xiao Cheng2, Xudong Feng3, Hong Wan1, Sihan Chen1, Maoming Xiong1. 1. Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China. 2. Department of Pathology, Anhui Medical University, Hefei, China. 3. Zhejiang University, Hangzhou, China.
Abstract
Objective: The prognosis of mild and severe patients has prominent differences during the prevalence of COVID-19, and it will be significant to identify patients' potential risk of progressing to severe cases according to their first clinical presentations. Therefore, we aim to review the clinical symptoms of the COVID-19 epidemic systematically. Methods: We searched PubMed, Embase, Web of Science, and CNKI (Chinese Database) for studies about the clinical features of COVID-19 in China from March 18 to April 18. Then we used REVMAN to conduct a meta-analysis. Results: After screening, 20 articles including 3,326 COVID-19 confirmed cases were selected from 142 articles we retrieved at the beginning of our research. We divided all the cases into a severe group (including severe and critically severe patients) and a mild group according to the "Diagnosis and Treatment Protocol for Novel Coronavirus Infection-Induced Pneumonia" version 4 (trial). Of all the initial symptoms (including fever, cough, abdominal pain, anorexia, chest tightness, diarrhea, dyspnea, expectoration, fatigue, headache, hemoptysis, myalgia, nausea or vomiting, and pharyngalgia) we studied, we found that cough (odds ratio [OR] = 1.4, 95% confidence interval [CI]: 1.2-1.7; p < 0.001), fever (OR = 1.5, 95% CI: 1.2-1.9; p < 0.001), dyspnea (OR = 6.2, 95% CI: 3.6-10.6; p < 0.001), diarrhea (OR = 2.6, 95% CI: 1.3-4.9; p < 0.001), fatigue (OR = 2.1, 95% CI: 1.3-3.3; p < 0.01), expectoration (OR = 1.7, 95% CI: 1.2-2.6; p < 0.01), myalgia (OR = 1.6, 95% CI: 0.8-3.1; p < 0.001), hemoptysis (OR = 4.0, 95% CI: 1.5-11.3; p < 0.001), abdominal pain (OR = 7.5, 95% CI: 2.4-23.4; p < 0.001), and anorexia (OR = 2.8, 95% CI: 1.5-5.1; p < 0.001) had a different distribution in two groups and were statistically significant (p < 0.05). Conclusion: COVID-19 patients whose initial manifestation is dyspnea, hemoptysis, anorexia, diarrhea, or fatigue, especially abdominal pain should be closely monitored to prevent disease deterioration.
Objective: The prognosis of mild and severe patients has prominent differences during the prevalence of COVID-19, and it will be significant to identify patients' potential risk of progressing to severe cases according to their first clinical presentations. Therefore, we aim to review the clinical symptoms of the COVID-19 epidemic systematically. Methods: We searched PubMed, Embase, Web of Science, and CNKI (Chinese Database) for studies about the clinical features of COVID-19 in China from March 18 to April 18. Then we used REVMAN to conduct a meta-analysis. Results: After screening, 20 articles including 3,326 COVID-19 confirmed cases were selected from 142 articles we retrieved at the beginning of our research. We divided all the cases into a severe group (including severe and critically severe patients) and a mild group according to the "Diagnosis and Treatment Protocol for Novel Coronavirus Infection-Induced Pneumonia" version 4 (trial). Of all the initial symptoms (including fever, cough, abdominal pain, anorexia, chest tightness, diarrhea, dyspnea, expectoration, fatigue, headache, hemoptysis, myalgia, nausea or vomiting, and pharyngalgia) we studied, we found that cough (odds ratio [OR] = 1.4, 95% confidence interval [CI]: 1.2-1.7; p < 0.001), fever (OR = 1.5, 95% CI: 1.2-1.9; p < 0.001), dyspnea (OR = 6.2, 95% CI: 3.6-10.6; p < 0.001), diarrhea (OR = 2.6, 95% CI: 1.3-4.9; p < 0.001), fatigue (OR = 2.1, 95% CI: 1.3-3.3; p < 0.01), expectoration (OR = 1.7, 95% CI: 1.2-2.6; p < 0.01), myalgia (OR = 1.6, 95% CI: 0.8-3.1; p < 0.001), hemoptysis (OR = 4.0, 95% CI: 1.5-11.3; p < 0.001), abdominal pain (OR = 7.5, 95% CI: 2.4-23.4; p < 0.001), and anorexia (OR = 2.8, 95% CI: 1.5-5.1; p < 0.001) had a different distribution in two groups and were statistically significant (p < 0.05). Conclusion:COVID-19patients whose initial manifestation is dyspnea, hemoptysis, anorexia, diarrhea, or fatigue, especially abdominal pain should be closely monitored to prevent disease deterioration.
Authors: Thomas G Ksiazek; Dean Erdman; Cynthia S Goldsmith; Sherif R Zaki; Teresa Peret; Shannon Emery; Suxiang Tong; Carlo Urbani; James A Comer; Wilina Lim; Pierre E Rollin; Scott F Dowell; Ai-Ee Ling; Charles D Humphrey; Wun-Ju Shieh; Jeannette Guarner; Christopher D Paddock; Paul Rota; Barry Fields; Joseph DeRisi; Jyh-Yuan Yang; Nancy Cox; James M Hughes; James W LeDuc; William J Bellini; Larry J Anderson Journal: N Engl J Med Date: 2003-04-10 Impact factor: 91.245
Authors: Qun Li; Xuhua Guan; Peng Wu; Xiaoye Wang; Lei Zhou; Yeqing Tong; Ruiqi Ren; Kathy S M Leung; Eric H Y Lau; Jessica Y Wong; Xuesen Xing; Nijuan Xiang; Yang Wu; Chao Li; Qi Chen; Dan Li; Tian Liu; Jing Zhao; Man Liu; Wenxiao Tu; Chuding Chen; Lianmei Jin; Rui Yang; Qi Wang; Suhua Zhou; Rui Wang; Hui Liu; Yinbo Luo; Yuan Liu; Ge Shao; Huan Li; Zhongfa Tao; Yang Yang; Zhiqiang Deng; Boxi Liu; Zhitao Ma; Yanping Zhang; Guoqing Shi; Tommy T Y Lam; Joseph T Wu; George F Gao; Benjamin J Cowling; Bo Yang; Gabriel M Leung; Zijian Feng Journal: N Engl J Med Date: 2020-01-29 Impact factor: 176.079
Authors: Wei Liu; Zhao-Wu Tao; Lei Wang; Ming-Li Yuan; Kui Liu; Ling Zhou; Shuang Wei; Yan Deng; Jing Liu; Hui-Guo Liu; Ming Yang; Yi Hu Journal: Chin Med J (Engl) Date: 2020-05-05 Impact factor: 2.628
Authors: Ahmed Ismail; Ahmed S Doghish; Walid F Elkhatib; Ahmed M Magdy; Eman E Mahmoud; Mona I Ahmed; Mahmoud A F Khalil Journal: PLoS One Date: 2022-07-08 Impact factor: 3.752
Authors: Heinrich Scheiblauer; Claudius Micha Nübling; Timo Wolf; Yascha Khodamoradi; Carla Bellinghausen; Michael Sonntagbauer; Katharina Esser-Nobis; Angela Filomena; Vera Mahler; Thorsten Jürgen Maier; Christoph Stephan Journal: J Clin Virol Date: 2021-12-04 Impact factor: 3.168
Authors: Hendris Wongso; Isa Mahendra; Wyanda Arnafia; Idar Idar; Muhammad Yusuf; Arifudin Achmad; Holis A Holik; Ahmad Kurniawan; Iim Halimah; Maula E Sriyani; Teguh H A Wibawa; Muhamad B Febrian; Yanuar Setiadi; Eva M Widyasari; Isti Daruwati; Crhisterra E Kusumaningrum; Toto Subroto Journal: Vaccines (Basel) Date: 2022-01-17