Clinical Characteristics of 20,662 Patients with COVID-19 Described in 147 Articles: A Systemic Review and Meta-Analysis

Background: Coronavirus disease 2019 (COVID-19) is a global pandemic and has been widely reported; however, a comprehensive systemic review and meta-analysis has not been conducted. We systematically investigated the clinical characteristics of COVID-19 in mainland China to guide diagnosis and treatment. Methods: We searched the PubMed, Embase, Scopus, Web of Science, Cochrane Library, bioRxiv, medRxiv, and SSRN databases for studies related to COVID-19 published or preprinted in English or Chinese from January 1 to March 15, 2020. Clinical studies on COVID-19 performed in mainland China were included. We collected primary outcomes including signs and symptoms, chest CT imaging, laboratory tests, and treatments. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers. The primary outcomes were the pooled incidence of items of clinical characteristics in patients with COVID-19. Qualitative and quantitative synthesis was conducted, and random-effects models were applied to pooled estimates. Findings: Of the 3624 records identified, 147 studies (20,662 patients) were analyzed. The mean age of patients with COVID-19 was 49·40 years, 53·45% were male, and 38.52% had at least one comorbidity. Fever and cough were the most common symptoms, followed by fatigue, expectoration, and shortness of breath. Most patients with COVID-19 had abnormal chest CT findings with ground glass opacity (70·70%) or consolidation (29·91%). Laboratory findings shown lymphopenia, increased lactate dehydrogenase, increased infection-related indicators, and fibrinolytic hyperactivity. Antiviral therapy, antibiotic therapy, and corticosteroids were administered to 89·75%, 79·13%, and 35·64% of patients, respectively. Interpretation: Most clinical characteristics of COVID-19 are non-specific. Patients with suspected should be evaluated by virological assays and clinically treated. Funding Statement: None Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study is registered with PROSPERO (number CRD42020171606).