This is the first report to provide a comprehensive overview of the available evidence on the SARS-CoV-19 outbreak.
Due to the novelty of the virus and the short duration of the SARS-CoV-2 outbreak, only a limited and scattered body of scientific evidence is available on various aspects of COVID-19. This review analyzes the published scientific literature on the SARS-CoV-2 infection worldwide concerning the clinical, epidemiological, laboratory and radiological characteristics of COVID-19, as well as its course, severity, and treatment options.
- 60 studies were included (case reports, case series or epidemiological reports) with a total of 59,254 patients from 11 countries.
- The most common symptoms in patients with SARS-CoV-19 infection were fever (82%), cough (61%), muscle aches and/or fatigue (36%) and dyspnea (26%).
- The most common chest radiographic abnormalities reported were bilateral opacities, multiple ground-glass shadows, infiltrate shadows and consolidation in the lungs, and thickening of the pulmonary texture.
- The most frequent computed tomographic abnormalities were ground-glass opacities, septal thickening and parenchymal consolidation.
- Mortality among the patients infected with SARS-CoV-19 was 3.0% and most of the data were from China.
- In epidemiological studies from China, male sex, age ≥ 60 years, delay in diagnosis and diagnosis of severe pneumonia were associated with increased mortality rates.
- The symptoms of COVID-19 are not specific, which makes it clinically indistinguishable from other viral respiratory illnesses.
- Fever is the most common manifestation of COVID-19, but the fever-free period of infection remains unknown, which may cause patients not to be identified initially, and some patients may even be asymptomatic.
- Non-respiratory symptoms such as headache, fatigue, sore throat and gastrointestinal symptoms should not be overlooked, and high suspicion should be maintained in those with a positive epidemiological history, followed up by thorough clinical evaluation by a healthcare provider.
- The rate of patients requiring admission to an intensive care unit was relatively low (8.3% among 1686 patients in which this outcome was assessed) but still may cause significant burden for healthcare systems worldwide.
- The use of supplementary oxygen therapy (38.9%), non-invasive (7.1%) and invasive ventilation (28.7%) and even ECMO (0.9%) was surprisingly high among the 1876 patients in which any kind of pharmacological and/or supportive intervention was reported, but no parameters of hypoxia, such as pO2 or SpO2, or even respiratory rate, were provided.
- Further research on all aspects of the disease is needed to better understand the infection, especially in regard to the rate of asymptomatic patients and beneficial treatments.